Individual provider Active NPI

Jennifer Lynn Kelly, D.O.

  • Hospitalist Physician
  • Crown Point, IN
National Provider Identifier
1942569959
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
02006177A Issued in IN
Practice address
1201 S Main St
Crown Point, IN 46307-8481
Phone
(219) 738-2100
Fax
(219) 933-2288
NPI assigned
May 10, 2012
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036.137522 IL
Hospitalist Physician 208M00000X 02006177A IN Primary
Hospitalist Physician 208M00000X 036.137522 IL

Addresses

Primary practice location

1201 S Main St
Crown Point, IN 46307-8481

Mailing address

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

Other practice location 1

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

Other practice location 2

20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone (708) 747-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkelly535383@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150803001238 IL Practitioner - Internal MedicinePractitioner - Hospitalist 0840504908 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 933-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.137522ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital Current Accepting new patients
Central Dupage Physician Group Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
KSB Medical Group, Inc. Internal Medicine CurrentSince May 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 28, 2018 Accepting new patients
Morris Hospital Current Accepting new patients
KSB Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Oct 15, 2020 Accepting new patients
Morris Hospital Current Accepting new patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 17, 2016 Accepting new patients
Morris Hospital CurrentSince Jun 3, 2019 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Morris Hospital Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 17, 2016 Accepting new patients
Central Dupage Physician Group CurrentSince Dec 1, 2021 Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Oct 15, 2020 Accepting new patients
Osf Multi-Specialty Group Internal Medicine CurrentSince Aug 9, 2018 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

800 W Oakton St
Arlington Hts, IL 60004
Phone (847) 253-3710

389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

29373 Network Pl
Chicago, IL 60673

9532 Eagle Way
Chicago, IL 60678

215 E 1st St
Ste 111
Dixon, IL 61021
Phone (815) 285-5477

215 E 1st St
Ste 117
Dixon, IL 61021
Phone (815) 285-5900

403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

150 W High St
Morris, IL 60450
Phone (815) 942-2129

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

9525 Mayfield Ave
Oak Lawn, IL 60453
Phone (708) 636-7000

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

Interoperability endpoints

  • Direct secure messaging: jkelly535383@direct.franciscanalliance.org

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1942569959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-933-4700",
            "fax_number": "630-933-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-738-2100",
            "fax_number": "219-933-2288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-933-4700",
            "fax_number": "630-933-4427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20201 Crawford Ave",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611010",
            "country_code": "US",
            "telephone_number": "708-747-4000",
            "fax_number": "219-933-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-10",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.137522",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "02006177A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.137522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkelly535383@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1201 S Main St",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463078481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.