MR. KEITH MICHAEL LADENDORF PA-C
NPI 1619092095
Physician Assistant - Surgical in Chicago, IL

Q: What is Keith Ladendorf's NPI number?

The NPI number for Keith Ladendorf is 1619092095. It was assigned to this individual provider in the NPPES registry on March 21, 2007.

Q: What is Keith Ladendorf's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Keith Ladendorf was last updated on January 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 21, 2007PECOS EnrolledAccepts Medicare Assignment

7447 W TALCOTT AVENUE, SUITE 512, CHICAGO, IL 60631(847) 788-1553(773) 577-8187 Get Directions Write a Review

NPPES record last updated: January 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Keith Michael Ladendorf Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KEITH MICHAEL LADENDORF PA-C (NPI 1619092095) is an individual surgical provider in Chicago, Illinois, licensed in Illinois (085002545) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Amita Health Resurrection Medical Center, and maintains a secondary practice location in Lafayette.

NPPES Registry Identity

NPI1619092095

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameMR. KEITH MICHAEL LADENDORFCredential: PA-C

Location Address7447 W TALCOTT AVENUE, SUITE 512Chicago, IL 60631

Mailing Address2650 Warrenville Road, Suite 280Downers Grove, IL 60515 · (630) 324-7911 · Fax (630) 324-7942

Phone(847) 788-1553

Fax(773) 577-8187

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateMarch 21, 2007

Last NPPES UpdateJanuary 23, 2023

NPPES CertifiedJanuary 23, 2023

✔ NPI 1619092095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Licenses✔ Licensed in IL · 085002545✔ Licensed in IL · 085-002545

7447 W TALCOTT AVENUE, Chicago, IL 60631

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Secondary Practice Location 1

Location 13900 St Francis Way Ste 200Lafayette, IN 47905-4940 · Phone (776) 775-2800

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Network Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Keith Michael Ladendorf Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698789402

PECOS Enrollment IDI20060201000184

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Coronary artery bypass using artery graft, 1 graft 33533

A coronary artery bypass with one artery graft is a surgical procedure to improve blood flow to your heart. An artery from another part of your body is used to bypass a blocked or narrowed coronary artery. This can help reduce chest pain and risk of heart attack.

19 services19 patients

Harvest of vein using an endoscope 33508

Harvesting a vein using an endoscope is a procedure where a small camera is used to help surgeons remove a vein from your body. This vein is often used to bypass a blocked artery, improving blood flow to your heart.

18 services18 patients

Coronary artery bypass using vein or artery graft, 2 grafts 33518

A coronary artery bypass with 2 grafts is a surgery to improve blood flow to your heart. A surgeon takes a healthy vein or artery from your body and attaches it to the blocked coronary artery. This creates a new path for blood to flow, bypassing the blockage.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Amita Health Resurrection Medical Center

Acute Care Hospitals · Chicago, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140117

Location7435 W Talcott AvenueChicago, IL 60631 · Cook County

Emergency services Birthing friendly

Trinity Rock Island

Acute Care Hospitals · Rock Island, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140280

Location2701 17th StRock Island, IL 61201 · Rock Island County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTHWEST ORTHOPAEDIC ASSOC LTD

Family Medicine

7447 W TALCOTT AVENUE, NORTHWEST ORTHOPAEDIC ASSOCIATES LTD SUITE 500
CHICAGO, IL 60631

Cook County (773) 631-7898

DR. DAVID A DEBOER M.D., MBA

Thoracic Surgery (Cardiothoracic Vascular Surgery)

7447 W TALCOTT AVENUE, STE. 512
CHICAGO, IL 60631

Cook County (773) 594-6460

DR. DANIEL E SULLIVAN MD

Orthopaedic Surgery

7447 W TALCOTT AVENUE, SUITE 500 NORTHWEST ORTHOPAEDIC ASSOCIATES LTD
CHICAGO, IL 60631

Cook County (773) 631-7898

DR. JEFFREY MARK SILVER MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

7447 W TALCOTT AVENUE, STE. 512
CHICAGO, IL 60631

Cook County (773) 594-6460

MRS. IWONA U SOBCZAK MD

Psychiatry & Neurology (Neurology)

7447 W TALCOTT AVENUE, SUITE #367
CHICAGO, IL 60631

Cook County (773) 957-0304

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Keith Ladendorf's NPI number?

The NPI number for Keith Ladendorf is 1619092095. It was assigned to this individual provider in the NPPES registry on March 21, 2007.

Where is Keith Ladendorf located?

Keith Ladendorf practices at 7447 W Talcott Avenue Suite 512, Chicago, IL 60631. The listed phone number is (847) 788-1553.

What is Keith Ladendorf's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Keith Ladendorf enrolled in Medicare?

Yes. Keith Ladendorf is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Keith Ladendorf accept?

Health plans from CareSource and Network Health list Keith Ladendorf as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Keith Ladendorf affiliated with any hospitals?

According to CMS data, Keith Ladendorf is affiliated with Amita Health Resurrection Medical Center and Trinity Rock Island.

When was this NPI record last updated?

The NPPES record for Keith Ladendorf was last updated on January 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.