Dr Patricia Ann Kelleher, MD is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Evanston, Illinois. Her current practice location is
2606 Grant St, Evanston, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 475-7041.
Dr Patricia Ann Kelleher is licensed to practice in Illinois (license number 036-088048) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1871518191.
Physician's Profile
| Full Name | Dr Patricia Ann Kelleher |
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| Gender | Female |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 2606 Grant St, Evanston, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1871518191
- Provider Enumeration Date: 07/13/2006
- Last Update Date: 08/10/2020
Medicare PECOS Information:
- PECOS PAC ID: 0244412054
- Enrollment ID: I20110315000271
Medical Identifiers
Medical identifiers for Dr Patricia Ann Kelleher such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1871518191 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083P0500X | Preventive Medicine - Preventive Medicine/occupational Environmental Medicine | 36-088048 (Illinois) | Secondary |
| 2083X0100X | Preventive Medicine - Occupational Medicine | 036-088048 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Patricia Ann Kelleher allows following entities to bill medicare on her behalf.
| Entity Name | Cook County |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588612832
PECOS PAC ID: 2860398088
Enrollment ID: O20031209000747 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Patricia Ann Kelleher is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Patricia Ann Kelleher, MD
1901 W Harrison St,
Chicago, IL 60612-3714
Ph: (312) 864-4665 | Dr Patricia Ann Kelleher, MD
2606 Grant St,
Evanston, IL 60201-2112
Ph: (847) 475-7041 |
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