DR. WILLIAM THOMAS KELLY III (NPI# 1215428156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215428156 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM THOMAS KELLY III |
| Credential | DNP, RN, APN, AGACNP |
| Practice Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Mailing Address |
1122 W Catalpa Ave Apt 605 Chicago IL 60640-7084 |
| Practice Telephone | 7082165118 |
| Mailing Telephone | 7739608606 |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2018-05-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
209.017727 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770138018 | William Ayers Kelly Iv | Specialist/Technologist | 1520 Hurst St, Fort Bragg, NC 28308 | 2019-08-05 |
| 1629574637 | William James Kelly | Nurse Practitioner | 590 George St, New Brunswick, NJ 08901-8531 | 2018-03-30 |
| 1881025302 | William Nathaniel Kelly IIi | Social Worker | 4205 Park Blvd, San Diego, CA 92103-2512 | 2013-12-09 |
| 1548392822 | William J. Kelly | Counselor | 22 Oak Tree Dr, N Kingstown, RI 02852-2035 | 2007-03-12 |
| 1699804567 | William Charles Kelly | Dentist | 42448 Cherry Hill, Canton, MI 48187 | 2007-03-05 |
| 1548351372 | William Huske Kelly | Pediatrics | 1606 Morganton Rd, Fayetteville, NC 28305-4738 | 2006-09-27 |
| 1013015908 | William J Kelly | Psychologist | 343 S 3rd St, Coopersburg, PA 18036-2111 | 2006-09-21 |
| 1194766394 | William Francis Kelly | Physician Assistant | 5100 Buckeystown Pike, Suite 186, Frederick, MD 21704-8336 | 2006-06-09 |
| 1689649402 | William James Kelly | Chiropractor | 160 Sunset Manor Dr, Birdsboro, PA 19508-1018 | 2006-02-23 |
| 1730170374 | William Sherwood Kelly | Family Medicine | 420 W Mountain St, Kernersville, NC 27284-2534 | 2005-11-02 |
| Street Address |
2160 S 1ST AVE |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525489 | Michael Jm Raffin | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2005-06-01 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1124634712 | Abhilasha Nitin Borkar | Pathology | 2160 S 1st Ave, Maywood, IL 60153 | 2020-09-18 |
| 1306450325 | Linda Ippolito | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339135 | Meghan Henry | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339911 | Victoria Leah Drozd | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-31 |
| 1396357588 | Madison Schaefer | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1134731375 | Otanthia S Williams-brady | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1205454287 | Janet Nickels | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-07-07 |
| 1417574054 | Kathryn Clemans | Nurse Anesthetist, Certified Registered | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245491281 | Vicki Ann Bacidore | Nurse Practitioner | 2160 S 1st Ave Bldg 110ll, Maywood, IL 60153-3328 | 2008-06-23 |
| 1396357588 | Madison Schaefer | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1043843832 | Camille Kidd Moses | Nurse Practitioner | 2106 S 1st Ave, Maywood, IL 60153-3304 | 2020-02-19 |
| 1518420074 | Karmen Busse | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-04-11 |
| 1124598909 | Stela Lapic | Nurse Practitioner | Loyola University Medical Center, 2160 South 1st Avenue, Maywood, IL 60153-3328 | 2018-12-05 |
| 1881127991 | Cynthia Gunsteen | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2017-04-05 |
| 1730621160 | Danielle Marie Scarola | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-11-16 |
| 1275958092 | Lisa Ann Rolnicki | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2014-03-03 |
| 1861739641 | Anna S Ryan | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2013-01-13 |
| 1891069902 | Dorota Pietrowski | Nurse Practitioner | 2160 S 1st Ave, Orthopaedic Surgery and Rehabilitation Maguire Center, Maywood, IL 60153-3328 | 2012-03-07 |
| Find all providers in MAYWOOD | ||||
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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.