ELIZABETH M KELLY (MSN) – Family Nurse Practitioner, NPI 1972873735

ELIZABETH M KELLY (MSN) is a healthcare provider. based in Maywood, Illinois. specializing in Family Nurse Practitioner. They hold the professional credentials MSN. They hold a License No. 209009226 (IL). The NPI Number for ELIZABETH M KELLY (MSN) is 1972873735

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
ELIZABETH M KELLY (MSN)
NPI
1972873735
Phone
(708) 216-9000
Address
2160 S 1ST AVE
Enumeration Date
10 January 2012
Last Update Date
29 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7082168372
Graduation Year
2011 (15 years ago)
PAC ID
7315104999
Group Practice PAC ID
3779488903
Professional Enrollment ID
I20120209000351

Contacts

Secure Messaging
ekelly35139@direct.luhs.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness85
Years active:14State licenses:1Other namesUpdated within 12 months

Provider Addresses for ELIZABETH M KELLY (MSN)

  • 2160 S 1ST AVE

    MAYWOOD, IL 601533328

    Phone: (708) 216-9000

    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 2 Open Payments records for all available years, with a total value of $188.

Total Amount is formed as General ($188) + Research ($0) + Ownership ($0) = $188.

Last reported payment date: 2023-07-19 • Largest payer in this snapshot: Aroa Biosurgery Incorporated ($188).

Total Amount

$188

General + Research + Ownership

Payments

2

Total payment records

General Amount

$188

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-07-19

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: 2012-02-09

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
I20120209000351INurse PractitionerILTBD

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 60153)

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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: 3779488903View full group profile

Reviews

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Frequently asked questions

Is ELIZABETH M KELLY (MSN) listed with a National Provider Identifier?
Yes — ELIZABETH M KELLY (MSN) has NPI 1972873735 on file in the registry.
Is ELIZABETH M KELLY (MSN) still an active registrant?
ELIZABETH M KELLY (MSN) carries an active NPI according to the public dataset.
What area of care is associated with ELIZABETH M KELLY (MSN)?
ELIZABETH M KELLY (MSN)'s record emphasizes Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with ELIZABETH M KELLY (MSN)?
Directory geography for ELIZABETH M KELLY (MSN) centers on Maywood, Illinois.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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