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KENNETH LYLE HOLLAND APRN
NPI 1679327266
Nurse Practitioner - Psychiatric/Mental Health in Broadview, IL

Active since April 11, 2024PECOS EnrolledAccepts Medicare Assignment
2325 S 18TH AVE, BROADVIEW, IL 60155(773) 706-5802 Get Directions Write a Review

NPPES record last updated: July 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2025, Jul 9, 2024, Apr 13, 2024 (3 updates tracked since 2024).

About Kenneth Lyle Holland Aprn NPPES

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

KENNETH LYLE HOLLAND APRN (NPI 1679327266) is an individual psychiatric/mental health provider in Broadview, Illinois, licensed in Illinois (209029961) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1679327266
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameKENNETH LYLE HOLLANDCredential: APRN
Location Address2325 S 18TH AVEBroadview, IL 60155-3927
Mailing Address2325 S 18th AveBroadview, IL 60155-3927
Phone(773) 706-5802
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateApril 11, 2024
Last NPPES UpdateJuly 9, 20253 updates tracked since enumeration
NPPES CertifiedJuly 9, 2025
✔ NPI 1679327266 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IL · 209029961
Also ListedRegistered Nurse · Psychiatric/Mental Health, Child & AdolescentTaxonomy 163WP0807X · License 041448188 (IL)
2325 S 18TH AVE, Broadview, IL 60155
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Secondary Practice Location 1

Location 11740 W Taylor StChicago, IL 60612-7232 · Phone (312) 996-2064

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

Kenneth Lyle Holland Aprn 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 ID1052810355
PECOS Enrollment IDI20250814003512
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60155 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kenneth Holland's NPI number?

The NPI number for Kenneth Holland is 1679327266. It was assigned to this individual provider in the NPPES registry on April 11, 2024.

Where is Kenneth Holland located?

Kenneth Holland practices at 2325 S 18th Ave, Broadview, IL 60155. The listed phone number is (773) 706-5802.

What is Kenneth Holland's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Kenneth Holland enrolled in Medicare?

Yes. Kenneth Holland 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.

When was this NPI record last updated?

The NPPES record for Kenneth Holland was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.