Jaclyn Keller

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036149646 Issued in IL

Practice address

300 Randall Rd
Geneva, IL 60134-4200

Phone

(630) 933-4700

Fax

(630) 933-4427

NPI assigned

Mar 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

HospitalistAlso: Internal Medicine

Education

Rush Medical College of Rush University, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice Compassus - Northwest Illinois Hospice, Galesburg, IL, CCN 141581
• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
• Lutheran Hillside Village Nursing home, Peoria, IL, CCN 145768

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkellermd442921@carlehiedirect.net

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.

• Carle Health Care Incorporated

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment Care Compare group NPD
• Proctor Health Systems

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1134173917

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  Internal Medicine

  Medicare reassignment NPD
• Cep America-Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Belleville, IL
  • NPI 1841613403
  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Cep America-Illinois Hospitalists

  • Hospitalist Physician
  • Bloomington, IL
  • NPI 1669276523
  NPD
• Cep America-Illinois Hospitalists, LLP

  • Internal Medicine Physician
  • Springfield, IL
  • NPI 1598532061
  NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  NPD
• Methodist Medical Center of Illinois

  • Psychiatric Hospital Unit
  • Peoria, IL
  • NPI 1275583155
  NPD
• Proctor Health Systems

  dba Carle Health Princeville

  • Rural Health Clinic/Center
  • Princeville, IL
  • NPI 1356057301
  NPD

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

• Community Hospices of America, LLC

  dba Hospice Compassus - Northwest Illinois

  • Community Based Hospice Care Agency
  • Galesburg, IL
  • NPI 1063514800
  Care Compare affiliation
• Lutheran Senior Services

  dba Lutheran Home, The

  • Skilled Nursing Facility
  • Peoria, IL
  • NPI 1174239826

  Nursing home

  Care Compare affiliation
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1982066494",
    "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": "300 RANDALL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344200",
            "telephone_number": "630-933-4700",
            "fax_number": "630-933-4427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 N Winfield Rd",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "IL",
            "postal_code": "601901222",
            "country_code": "US",
            "telephone_number": "630-933-4700",
            "fax_number": "630-933-4427",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-5368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JACLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036149646",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036149646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Kavcar
• Kavita Nana PC (Randall Pointe Dental)
• Maureen A Kawka, CRNA
• James Keen, M.D.
• John A Kefer, M.D.
• Christopher Kelly, PT
• Debra A Kelly, OTR
• Marianne K Kelly, LCSW
• Sarah Jean Kendra, LCSW
• Raelene D Kennedy Kim, MD

• Internal Medicine Physician in Geneva, IL
• Providers in Geneva, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.