DR. KELLY MARIE MAXWELL (NPI# 1528216108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528216108 |
| Entity Type | Individual |
| Full Name | DR. KELLY MARIE MAXWELL |
| Credential | M.D. |
| Practice Address |
676 N Saint Clair St Suite 1835 Chicago IL 60611-2927 |
| Practice Telephone | 3129263535 |
| Practice Fax Number | 3129263585 |
| Mailing Telephone | 3129263535 |
| Mailing Fax Number | 3129263585 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2019-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036118400 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942855416 | Kelly Maxwell | Physical Therapy Assistant | 6351 S Desert Blvd Bldg C, El Paso, TX 79932-1219 | 2019-08-01 |
| 1730687328 | Kelly Maxwell | Nurse Practitioner | 700 E University Ave, Des Moines, IA 50316-2302 | 2018-01-29 |
| 1295032142 | Kelly Jo Maxwell | Physical Therapy Assistant | 3041 Charlevoix Dr Se, Grand Rapids, MI 49546-7035 | 2011-02-11 |
| 1861727109 | Kelly Ann Maxwell | Counselor | 9378 Olive Blvd, Ste. 317, Saint Louis, MO 63132-3215 | 2009-10-05 |
| 1083802565 | Kelly Maxwell | Pharmacist | 1500 N Westwood Blvd, Poplar Bluff, MO 63901-3318 | 2007-10-09 |
| 1972651669 | Kelly A Maxwell | Nurse Practitioner | 7125 Saltsburg Rd, Pittsburgh, PA 15235-2252 | 2007-01-08 |
| Street Address |
676 N SAINT CLAIR ST SUITE 1835 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60611-2927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285637272 | Alan Ara Boghosian | Dentist | 676 N Saint Clair St, Ste 1773, Chicago, IL 60611-2974 | 2005-05-24 |
| 1720542806 | Lindsey Lemmen | Social Worker | 676 N Saint Clair St, Chicago, IL 60611-2927 | 2019-01-23 |
| 1235633652 | Spencer Ng | Dermatology | 676 N Saint Clair St, Chicago, IL 60611 | 2018-03-20 |
| 1285168229 | Courtney Sperry | Physician Assistant | 676 N Saint Clair St, Suite 800, Chicago, IL 60611-2927 | 2017-04-17 |
| 1255872644 | Amanda Heepke | Nurse Practitioner | 676 N Saint Clair St, Suite 2125, Chicago, IL 60611-2927 | 2017-03-17 |
| 1295271088 | Roger Stupp | Internal Medicine | 676 N Saint Clair St, Suite 2210, Chicago, IL 60611-2927 | 2017-01-17 |
| 1356885099 | Jessica Mckinley | Nurse Practitioner | 676 N Saint Clair St, 9-900, Chicago, IL 60611-2927 | 2016-12-15 |
| 1376087239 | Sarah Hemphill | Social Worker | 676 N Saint Clair St, Chicago, IL 60611-2927 | 2016-12-12 |
| 1356885453 | Anne Kurze | Nurse Practitioner | 676 N Saint Clair St, 940, Chicago, IL 60611-2927 | 2016-12-07 |
| 1124562319 | Carolyn Chiu | Speech-Language Pathologist | 676 N Saint Clair St, Suite 1775, Chicago, IL 60611-2927 | 2016-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092835 | Lauren Less | Social Worker | 111 East Pearson St, Chicago, IL 60611 | 2020-10-29 |
| 1134735962 | Kalvin Cheuk Hang Lung | Student in an Organized Health Care Education/Training Program | 675 N St Clair St 17th Floor, Chicago, IL 60611 | 2020-09-17 |
| 1487267845 | Ashley Marie Sablich | Student in an Organized Health Care Education/Training Program | 250 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2020-08-26 |
| 1245854033 | Danielle Humphrey | Student in an Organized Health Care Education/Training Program | Pa Program, Suite 1-200, 240 East Huron Street, Chicago, IL 60611 | 2020-06-08 |
| 1801418074 | Sana Healing Collective | Clinic/Center | 405 N. Wabash Street, Chicago, IL 60611 | 2020-05-11 |
| 1194359489 | Insight:eating Disorders, Weight Management & Psychological Centers | Psychiatric Hospital | 1 E. Erie Street, 4th Floor, Chicago, IL 60611 | 2020-02-26 |
| 1902439193 | Iwona Boska | Nurse Practitioner | 676 N St.clair Street, Suite 2140, Chicago, IL 60611 | 2020-02-17 |
| 1922643576 | Sarah Elizabeth Schwartzer | Audiologist | Chicago Dizziness and Hearing, 645 North Michigan Avenue, Suite 410, Chicago, IL 60611 | 2019-11-07 |
| 1023668852 | Anne Marguerite Davidson | Student in an Organized Health Care Education/Training Program | Mcgraw Medical Center, 240 E Huron Street, Suite 1-200, Chicago, IL 60611 | 2019-09-13 |
| 1871141085 | Coast Management | Durable Medical Equipment & Medical Supplies | 40 E. Chicago Ave, Suite 149, Chicago, IL 60611 | 2019-08-30 |
| Find all providers in zip 60611 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699236612 | Behdod Katebian | Urology | 5841 S Maryland Ave Rm J-653, Chicago, IL 60637-1443 | 2019-03-31 |
| 1134657026 | Soojin Kim | Urology | 225 E. Chicago Avenue, Box 24, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611 | 2017-05-23 |
| 1790164002 | Shay Golan | Urology | 5841 S Maryland Ave Mc6038, Chicago, IL 60637-1447 | 2015-05-20 |
| 1528453594 | Christopher Stockdale | Urology | 300 W Hill St Apt 707, Chicago, IL 60610-7537 | 2015-04-06 |
| 1639568447 | Jeremy Lai | Urology | 420 E Superior St Ste 9-900, Chicago, IL 60611-4494 | 2015-01-16 |
| 1174933048 | Kyle John Ericson | Urology | 924 E 57th St, Suite 104, Chicago, IL 60637-1455 | 2014-05-01 |
| 1467878314 | Oluwarotimi Sewedo Nettey | Urology | 1524 S. Sangamon Street, Unit 403, Chicago, IL 60608 | 2014-03-14 |
| 1881957405 | Ricardo R Rios | Urology | 5600 W Addison St Ste 305, Chicago, IL 60634-4468 | 2012-06-19 |
| 1972863124 | James Wren | Urology | 675 N Saint Clair St Fl 20, Chicago, IL 60611 | 2012-05-22 |
| 1780940023 | Ryan Patrick Werntz | Urology | 5841 S Maryland Ave # 6038, Chicago, IL 60637-1447 | 2012-04-11 |
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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.