KELLIE JANSSEN (NPI# 1194014498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194014498 |
| Entity Type | Individual |
| Full Name | KELLIE JANSSEN |
| Credential | PA-C |
| Practice Address |
4700 Gilbert Ave Ste 51 Western Springs IL 60558-1664 |
| Practice Telephone | 7083871737 |
| Practice Fax Number | 7083871739 |
| Mailing Telephone | 7083871737 |
| Mailing Fax Number | 7083871739 |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2018-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085003980 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 5601006624 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601006624 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SN0800X |
Clinical Nurse Specialist Specialization: Neuroscience |
5601006624 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | PHYSICIAN ASSISTANT LICENSE | 085003980 | 01 |
| Street Address |
4700 GILBERT AVE STE 51 |
| City | WESTERN SPRINGS |
| State | IL |
| Zip Code | 60558-1664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861703233 | Thomas Andrew Ehmke | Orthopaedic Surgery | 4700 Gilbert Ave Ste 51, Western Springs, IL 60558-1664 | 2010-06-30 |
| 1144836883 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 4700 Gilbert Ave Ste 51, Western Springs, IL 60558-1664 | 2020-09-18 |
| 1174148100 | Michelle Presslak | Physical Therapist | 4700 Gilbert Ave Ste 51, Western Springs, IL 60558-1664 | 2020-06-16 |
| 1770096000 | Lesli Elizabeth Frank | Physician Assistant | 4700 Gilbert Ave Ste 51, Western Springs, IL 60558-1664 | 2017-11-08 |
| 1649578097 | Rachel Scrementi | Physical Therapist | 4700 Gilbert Ave Ste 51, Western Springs, IL 60558 | 2011-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194280941 | Kenneth J. Szafranski, Dds, Ltd Matthew S. Van Beek, Dds | Dentist | 1100 Hillgrove Ave, Suite 1&2, Western Springs, IL 60558 | 2019-02-06 |
| 1942782313 | Tom Schimel | Counselor | 1023 Burlington Avenue, Western Springs, IL 60558 | 2018-09-03 |
| 1760904692 | Megan Sullivan | Social Worker | 1405 Willow Ave., Western Springs, IL 60558 | 2017-07-12 |
| 1205281763 | Cara Bowton | Student in an Organized Health Care Education/Training Program | 4051 Linden Ave, Western Springs, IL 60558 | 2016-05-03 |
| 1598109803 | Megan Marie Tierney | Student in an Organized Health Care Education/Training Program | 5001 Lawn Ave, Western Springs, IL 60558 | 2013-04-18 |
| 1013275189 | Farouk Fahim Girgis | Specialist | 5731 Grand Avenue, Western Springs, IL 60558 | 2012-04-26 |
| 1346516507 | Dara Kruchko | Occupational Therapist | 3839 Central Ave., Western Springs, IL 60558 | 2012-03-31 |
| 1346540697 | John Vrchota IIi | Pharmacist | #14 Garden Market St, Western Springs, IL 60558 | 2010-11-02 |
| 1447574637 | Ryan Schmaedeke | Physical Therapist | 4700 Gilbert Ave Ste 43a, Western Springs, IL 60558 | 2010-03-17 |
| 1043463664 | Matthew David Peahl | Chiropractor | 1052 Hillgrove Ave., Western Springs, IL 60558 | 2008-10-28 |
| Find all providers in zip 60558 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770096000 | Lesli Elizabeth Frank | Physician Assistant | 4700 Gilbert Ave Ste 51, Western Springs, IL 60558-1664 | 2017-11-08 |
| 1275069296 | Lawrence Kocen | Physician Assistant | 4700 Gilbert Ave, Suite 51,52, Western Springs, IL 60558-1753 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063010924 | Mckenzie Youngblood | Physician Assistant | 28653 Wren Ln, Jerseyville, IL 62052-6501 | 2020-10-13 |
| 1548877400 | Shawn Milhauser | Physician Assistant | 1014 N Mill St, Pontiac, IL 61764-1332 | 2020-09-25 |
| 1982210654 | Brittany Michelle Weber | Physician Assistant | 525 E Congress Pkwy Ste 200, Crystal Lake, IL 60014-6271 | 2020-09-18 |
| 1003421603 | Logan M Barkley | Physician Assistant | 2560 24th St Ste 201, Rock Island, IL 61201-5390 | 2020-09-10 |
| 1336753342 | Navneet Kaur Bamrah | Physician Assistant | 11316 S Highland Dr, Plainfield, IL 60585-1581 | 2020-09-07 |
| 1306450424 | Annie Mannancheril | Physician Assistant | 9114 Waukegan Rd, Morton Grove, IL 60053-2135 | 2020-09-04 |
| 1508470709 | Bryan Ying Wong | Physician Assistant | 3420 S Morgan St Apt 2e, Chicago, IL 60608-6904 | 2020-09-04 |
| 1386256402 | Emma Schmidt | Physician Assistant | 20 Haverton Ct, Streamwood, IL 60107-1682 | 2020-08-19 |
| 1063024388 | Alyson Dyck | Physician Assistant | 2540 Health Services, Ssb Student Services Building, Normal, IL 61790-2540 | 2020-08-18 |
| 1649882192 | Anna Marie Phillips | Physician Assistant | 5337 Main St, Skokie, IL 60077-2029 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
| City | WESTERN SPRINGS |
| Zip Code | 60558 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.