MS. KATHRYN ILISSA ROSS (PA-C) – Physician Assistant, NPI 1124434014
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. KATHRYN ILISSA ROSS (PA-C)
13755 CICERO AVE
CRESTWOOD, IL 604181824
Phone:
Type: Mailing
676 N SAINT CLAIR ST FL 14
CHICAGO, IL 60611
Phone: (312) 695-5620
Type: Location
259 E ERIE ST STE 1600
CHICAGO, IL 606113111
Phone: (312) 695-5620
Fax: (312) 695-2310
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 123 Open Payments records for all available years, with a total value of $2,806.
Total Amount is formed as General ($2,806) + Research ($0) + Ownership ($0) = $2,806.
Last reported payment date: 2024-06-12 • Largest payer in this snapshot: ABBVIE INC. ($705).
Total Amount
$2,806
General + Research + Ownership
Payments
123
Total payment records
General Amount
$2,806
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $705 |
| Otsuka America Pharmaceutical, Inc. | $558 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $231 |
| ITI, Inc. | $206 |
| Neos Therapeutics, LP | $162 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190711001074 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60418)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Diagnostic Radiology, Interventional Radiology | IL | |
| P A T H O L O G Y | IL | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| G A S T R O E N T E R O L O G Y | IL | |
| Internal Medicine | IL | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology), Internal Medicine | MN | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Nurse Practitioner | IL |
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