Individual provider Active NPI

Kelly Denise Zwiers, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1972913952
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277002145 Issued in IL
Practice address
1165 N Clark St Ste 305
Chicago, IL 60610-7862
Phone
(312) 880-9913
NPI assigned
Apr 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95003237 CA
Nurse Practitioner 363L00000X 277002145 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277002145 IL Primary

Addresses

Primary practice location

1165 N Clark St Ste 305
Chicago, IL 60610-7862

Mailing address

1165 N Clark St Ste 305
Chicago, IL 60610-7862
Phone (312) 880-9913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160405001517 CA Practitioner - Nurse Practitioner 7719284892 Reassigns benefits to 1 organization
I20210723002600 IL Practitioner - Nurse Practitioner 7719284892 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
277002145ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Mar Monte, Inc Current Accepting new patients
Planned Parenthood Mar Monte, Inc. CurrentSince Jan 8, 2017 Accepting new patients
Planned Parenthood Mar Monte, Inc CurrentSince Jan 8, 2017 Accepting new patients
Santa Cruz Medical Clinic, Inc PastSince Feb 22, 2016 Accepting new patients
Planned Parenthood Mar Monte, Inc PastSince Jan 8, 2017 Accepting new patients

Locations

316 N Main St
Salinas, CA 93901
Phone (831) 758-8261

316 N Main St
Ste 200
Salinas, CA 93901
Phone (831) 758-8261

1691 The Alameda
San Jose, CA 95126
Phone (408) 287-7526

398 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 724-7525

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1972913952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 N CLARK ST STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107862",
            "telephone_number": "312-880-9913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 N CLARK ST STE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107862",
            "telephone_number": "312-880-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWIERS",
        "first_name": "KELLY",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-30",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95003237",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277002145",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277002145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.