CHAD MICHAEL KELLER


Address: 2650 Ridge Ave., Burch 100, Cardiac Surgery Division, Evanston, IL 60201
Phone: 8475702859

CHAD MICHAEL KELLER (NPI# 1487875209) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487875209
Entity Type Individual
Full Name CHAD MICHAEL KELLER
Credential PA
Practice Address 2650 Ridge Ave.
Burch 100, Cardiac Surgery Division
Evanston
IL 60201
Mailing Address 2650 Ridge Ave
Evanston Hospital
Evanston
IL 60201
Practice Telephone 8475702859
Practice Fax Number 8475702899
Mailing Telephone 8475701206
Mailing Fax Number 8475701248
Enumeration Date 2007-05-01
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
IL Physician Assistants & Advanced Practice Nursing Providers

Other Providers CHAD KELLER

NPI Name Taxonomy Address Enumeration
1952600983 Chad John Keller Psychologist 7700 Clayton Rd Ste 103, Saint Louis, MO 63117-1345 2011-03-16
1003100082 Chad Robert Keller Otolaryngology 2131 E State St, Athens, OH 45701-2138 2011-06-07
1760613467 Chad G Keller Physical Therapist 1205 York Rd, Suite 19, Lutherville, MD 21093-6210 2009-07-30
1720052640 Chad J Keller Registered Nurse 5500 E Kellogg Dr, Wichita, KS 67218-1607 2006-02-15

Office Location

Street Address 2650 RIDGE AVE.
BURCH 100, CARDIAC SURGERY DIVISION
City EVANSTON
State IL
Zip Code 60201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1407841414 Sidney P. Regalado Radiology 2650 Ridge Ave., Department of Radiology, Evanston, IL 60201-1718 2005-09-15
1417554130 Stephanie Rene Gerberding Social Worker 2650 Ridge Ave., Dept. of Psychiatry, Evanston, IL 60202-1011 2020-10-06
1376196006 Brenna Selena Leiker Physician Assistant 2650 Ridge Ave., Emergency Medicine, Evanston, IL 60201-1718 2019-07-22
1225598022 Lindsey Weder Zimmerman Nurse Anesthetist, Certified Registered 2650 Ridge Ave., Department of Anesthesia, Evanston, IL 60201-1718 2019-03-20
1265996631 Madeline S. Lubenow Nurse Anesthetist, Certified Registered 2650 Ridge Ave., Department of Anesthesia, Evanston, IL 60201-1718 2019-01-30
1295203768 Gayathri S. Moorthy Registered Nurse 2650 Ridge Ave., Kellogg Cancer Center, Evanston, IL 60201-1718 2018-11-02
1700385077 Glenna M Daugherty Nurse Practitioner 2650 Ridge Ave., Emergency Medicine, Evanston, IL 60201-1718 2018-02-01
1164942066 Danijela Dokic Internal Medicine 2650 Ridge Ave., Im Hospitalists Ste 4210, Evanston, IL 60201 2017-06-21
1417487612 Julie Elaine Rzeszutko Internal Medicine 2650 Ridge Ave., Im Hospitalists Ste 4210, Evanston, IL 60201 2017-06-20
1144757154 Bukurije Alijoski Nurse Practitioner 2650 Ridge Ave., Palliative Care, Evanston, IL 60201-1718 2017-05-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356962898 Sebastian Andres Cruz Internal Medicine Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 2020-05-06
1053970442 Wade Gilman Family Medicine 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 2019-06-10
1922577949 Elizabeth Wilton Therapy, LLC Counselor 2901a Central St Ste 3, Evanston, IL 60201 2018-11-20
1952887812 Sg Wellness LLC Clinic/Center 3008 Central Street, Evanston, IL 60201 2018-07-13
1689169591 Michael Kert Zijlstra Internal Medicine Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 2018-06-25
1982199725 Elizabeth Hannah Lees Internal Medicine Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 2018-06-25
1730674565 Ashley Elizabeth Aller Internal Medicine Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 2018-06-25
1669967683 Ayush N Shah Internal Medicine 2650 Ridge Ave Ste 5315, Evanston, IL 60201 2018-06-22
1811481062 Jeffrey D. Brow Internal Medicine 2650 Ridge Ave Rm 5315, Evanston, IL 60201 2018-06-20
1831687250 Michael Patrick Murphy Radiology 807 Davis St. Unit 707, Evanston, IL 60201 2018-05-01
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821642455 Rachel Marie Supple Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1700 2019-07-31
1346721586 Megan Rachael Butzke Physician Assistant 2650 Ridge Ave, Evanston, IL 60201 2018-08-26
1538655865 Rachel Winkle Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1781 2018-07-10
1982134953 Katherine Frawley Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1718 2017-06-13
1396298311 Stacey Lewis Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1718 2016-07-26
1215391792 Grazyna Urbanczyk Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1718 2016-04-11
1922474824 Alison Glinski Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1718 2015-08-13
1750767919 Taebee Chang Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1718 2015-08-10
1245612548 Katherine Anne Niekamp Physician Assistant 2650 Ridge Ave., Walgreen 2507, Evanston, IL 60201-1718 2015-06-23
1518376680 Elizabeth Ahlgrimm Physician Assistant 2650 Ridge Ave, Evanston, IL 60201-1718 2014-08-03
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Competitor

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City EVANSTON
Zip Code 60201

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Dataset Information

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.

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