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NPI Code Detail

MEDICARE: MRS. JANE PELOSI-KELLY APN

MEDICARE: MRS. JANE PELOSI-KELLY APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner209003572IL
2363LA2200XAdult Health Nurse Practitioner277004198IL
3363L00000XNurse Practitioner277004198IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1T01883OTHERILMEDICARE (INDIVIDUAL)
2206147OTHERILMEDICARE RAILROAD (GROUP)
3CA4748OTHERILMEDICARE RAILROAD (GROUP)
4P01013429OTHERILMEDICARE RAILROAD (INDIVIDUAL)

General Provider Information

NPI Number : 1275730574
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANE PELOSI-KELLY APN
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 155 E BRUSH HILL RD
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5658
Country : US
Telephone Number : 331-221-0096
Fax Number : 331-221-3718
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 04/22/2026

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