Individual provider Active NPI

Brenda Keener, PA C

  • Physician Assistant
  • Joliet, IL
National Provider Identifier
1992745491
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085001908 Issued in IL
Practice address
2100 Glenwood Avenue
Joliet, IL 60435
Phone
(815) 725-2121
Fax
(815) 741-6303
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085001908 IL Primary

Addresses

Primary practice location

2100 Glenwood Avenue
Joliet, IL 60435

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 469-2000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040630000535 IL Practitioner - Physician Assistant 3375520190 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

100 Gore Rd
Morris, IL 60450-9466
Phone (815) 942-0545

101 S Prairie Ave
Dwight, IL 60420-1350
Phone (815) 584-3291

1450 E Division St
Morris Hospital Diamond Coal City Campus
Diamond, IL 60416-6050
Phone (815) 634-3500

150 W High St
Morris, IL 60450-1463
Phone (815) 942-2932

Hospital & facility affiliations

  • Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital CurrentSince Apr 1, 2024 Accepting new patients
Morris Hospital Current Accepting new patients
Morris Hospital CurrentSince Apr 1, 2024 Accepting new patients
Morris Hospital Past Accepting new patients
Emergency Medicine Physicians of Will County, LLC Past Accepting new patients

Locations

27240 W Saxony Dr
Fl First
Channahon, IL 60410

1450 E Division St
Diamond, IL 60416
Phone (815) 364-3500

100 Gore Rd
Morris, IL 60450
Phone (815) 364-8919

1051 W US Route 6
Ste 100
Morris, IL 60450
Phone (815) 942-4875

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

1051 W US Route 6
Ste 10
Morris, IL 60450
Phone (815) 942-4875

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.

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1992745491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD AVENUE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-725-2121",
            "fax_number": "815-741-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENER",
        "first_name": "BRENDA",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.