DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) – Family Medicine Physician, NPI 1154769081

DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) is a healthcare provider. based in Chicago, Illinois. specializing in FAMILY PRACTICE. They hold the professional credentials D.O.. They hold a License No. 125063705 (IL). The NPI Number for DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) is 1154769081

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEANNETTE SUZANNE CODERE KELLY (D.O.)
NPI
1154769081
Phone
(312) 994-3000
Address
180 N MICHIGAN AVE STE 1605
Enumeration Date
13 June 2013
Last Update Date
12 September 2019

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
7087632328
Graduation Year
2013 (13 years ago)
PAC ID
7810120714
Group Practice PAC ID
5991046468
Professional Enrollment ID
I20160713002781
Address ID
IL603022519OA3XXXXCTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

5,037 FAMILY PRACTICE in IL

Provider Addresses for DR. JEANNETTE SUZANNE CODERE KELLY (D.O.)

  • 180 N MICHIGAN AVE STE 1605

    CHICAGO, IL 606017478

    Phone: (312) 994-3000

    Fax: (612) 201-1202

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $74.

Total Amount is formed as General ($74) + Research ($0) + Ownership ($0) = $74.

Last reported payment date: 2024-08-06 • Largest payer in this snapshot: Globus Medical, Inc. ($49).

Total Amount

$74

General + Research + Ownership

Payments

3

Total payment records

General Amount

$74

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-06

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-07-13

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160713002781IFamily PracticeILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 60601)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5991046468View full group profile
NameSpecialtyState
R H E U M A T O L O G YIL
Nurse PractitionerIL
Internal MedicineIL
Diagnostic RadiologyIL
Clinical PsychologistIL
Family PracticeIL
O B S T E T R I C S/ G Y N E C O L O G YIL
Hematology/Oncology, Internal MedicineIL
Diagnostic RadiologyMD
Diagnostic RadiologyND

Reviews

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Frequently asked questions

What federal number belongs to DR. JEANNETTE SUZANNE CODERE KELLY (D.O.)?
The federal identifier for DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) is NPI 1154769081.
Is DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) active in the national directory?
DR. JEANNETTE SUZANNE CODERE KELLY (D.O.)'s public NPI profile is in an active state.
What field does DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) work in?
You can think of DR. JEANNETTE SUZANNE CODERE KELLY (D.O.) as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. JEANNETTE SUZANNE CODERE KELLY (D.O.)?
The page summarizes Chicago, Illinois for DR. JEANNETTE SUZANNE CODERE KELLY (D.O.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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