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MACKENZIE KELLY
NPI 1902285869
Psychologist - Clinical in Chicago, IL

Active since May 26, 2015PECOS EnrolledAccepts Medicare Assignment
1645 W JACKSON BLVD STE 400, CHICAGO, IL 60612(312) 942-5932(312) 942-4990 Get Directions Write a Review

NPPES record last updated: December 5, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mackenzie Kelly NPPES

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

MACKENZIE KELLY (NPI 1902285869) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (071-009818) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Danville, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1902285869
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMACKENZIE KELLY
Location Address1645 W JACKSON BLVD STE 400Chicago, IL 60612
Mailing Address1645 W Jackson Blvd Ste 400Chicago, IL 60612-3244 · (312) 942-5932 · Fax (312) 942-4990
Phone(312) 942-5932
Fax(312) 942-4990
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateMay 26, 2015
Last NPPES UpdateDecember 5, 2018
✔ NPI 1902285869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071-009818
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1645 W JACKSON BLVD STE 400, Chicago, IL 60612
Open in Google Maps ↗

Secondary Practice Location 1

Location 1100 N Academy AveDanville, PA 17822-9800 · Phone (570) 271-6516

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Mackenzie Kelly 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 ID5698010965
PECOS Enrollment IDI20181214002835
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 60612 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
$183.39 typical visit price
range $60.08 – $183.39
Typical copayment $45.84 (range $15.02 – $45.84)
Most-billed visit code 99205
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.

Other Providers at the Same Location NPPES 11

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

DR. MICHELLE L MILLER PHD
Psychologist (Clinical)
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-8258
AVIVA ARIEL-DONGES PHD, MPH
Psychologist (Clinical)
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-5932
JOYCE TAM PHD
Clinical Neuropsychologist
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-5932
RACHEL LEAH BOUTTE
Psychologist (Counseling)
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-5375
MRS. TAYLOR R NICOLETTI
Student in an Organized Health Care Education/Training Program
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-7100
DR. ALYSON KAY ZALTA PH.D.
Psychologist (Clinical)
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 563-2828
CHRISTINA SOUV KHOU PHD
Psychologist (Clinical)
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-5932
DR. TERESA LILLIS PHD
Psychologist (Clinical)
1645 W JACKSON BLVD STE 400
CHICAGO, IL 60612
Cook County (312) 942-6011

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 Mackenzie Kelly's NPI number?

The NPI number for Mackenzie Kelly is 1902285869. It was assigned to this individual provider in the NPPES registry on May 26, 2015.

Where is Mackenzie Kelly located?

Mackenzie Kelly practices at 1645 W Jackson Blvd Ste 400, Chicago, IL 60612. The listed phone number is (312) 942-5932.

What is Mackenzie Kelly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mackenzie Kelly enrolled in Medicare?

Yes. Mackenzie Kelly 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 Mackenzie Kelly accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Mackenzie Kelly 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.

When was this NPI record last updated?

The NPPES record for Mackenzie Kelly was last updated on December 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.