DR. ANDREA BACON (M.D.) – Psychiatry Physician, NPI 1194763433

DR. ANDREA BACON (M.D.) is a healthcare provider. based in Flossmoor, Illinois. specializing in PSYCHIATRY. They hold the professional credentials M.D.. The NPI Number for DR. ANDREA BACON (M.D.) is 1194763433

Main info

Female
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREA BACON (M.D.)
NPI
1194763433
Phone
(708) 799-2200
Address
19530 KEDZIE AVE
Enumeration Date
2 June 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Secondary Phone
6302611210
Graduation Year
1993 (33 years ago)
PAC ID
7911951124
Group Practice PAC ID
0042374720
Professional Enrollment ID
I20050310000536
Address ID
IL601485397LO2340XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:20State licenses:0Digital endpointsOther names

1,367 PSYCHIATRY in IL

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Provider Addresses for DR. ANDREA BACON (M.D.)

  • 19530, Kedzie Avenue, Sunny Crest, Flossmoor, Rich Township, Cook County, Illinois, 60422, United States

    FLOSSMOOR, IL 604221778

    Phone: (708) 799-2200

    Fax: (708) 922-4455

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2005-03-10

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
I20050310000536IPsychiatryILTBD

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 60422)

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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: 0042374720View full group profile
NameSpecialtyState
Physician AssistantIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
P S Y C H I A T R YIL
Clinical Social WorkerIL
Clinical Social WorkerIL
Nurse PractitionerIL
Mental Health CounselorIL
Clinical Social WorkerIL
Mental Health CounselorIL

Reviews

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Frequently asked questions

Does DR. ANDREA BACON (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. ANDREA BACON (M.D.) uses 1194763433.
Does the file indicate DR. ANDREA BACON (M.D.) is practicing under active NPI?
Directory data currently reports DR. ANDREA BACON (M.D.) as active.
What is DR. ANDREA BACON (M.D.)'s primary classification?
Psychiatry Physician is the headline specialty for DR. ANDREA BACON (M.D.) here. Clinical services aligned with this taxonomy classification.
What area does DR. ANDREA BACON (M.D.) serve?
DR. ANDREA BACON (M.D.)'s listing highlights Flossmoor, Illinois; more addresses can appear in NPPES.
Is the information about DR. ANDREA BACON (M.D.) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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