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MARY LOUISE KELLY D.O.
NPI 1912087560
Family Medicine in Oak Park, IL

Active since October 17, 2006PECOS Enrolled
1125 WESTGATE ST, OAK PARK, IL 60301(708) 848-0040(708) 848-2931 Get Directions Write a Review

NPPES record last updated: December 18, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mary Louise Kelly D.o. NPPES

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

MARY LOUISE KELLY D.O. (NPI 1912087560) is an individual family medicine provider in Oak Park, Illinois, licensed in Illinois (036077560) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912087560
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMARY LOUISE KELLYCredential: D.O.
Location Address1125 WESTGATE STOak Park, IL 60301-1007
Mailing Address1125 Westgate StOak Park, IL 60301-1007 · (708) 848-0040 · Fax (708) 848-2931
Phone(708) 848-0040
Fax(708) 848-2931
Sole ProprietorNo
Enumeration DateOctober 17, 2006
Last NPPES UpdateDecember 18, 2013
✔ NPI 1912087560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036077560
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1125 WESTGATE ST, Oak Park, IL 60301
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Other Identifiers 4

Medicare UPIND89609
Other01625396Blue Cross
Other2027403Aetna
Medicaid362182170IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Louise Kelly D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Kelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Edward Health Ventures
6.8 mi
Clinic/Center
1200 S YORK ST, STE 3160
Elmhurst, IL 60126
  • Reassigned Medicare billing, Illinois enrollment
  • 561 clinicians in this Medicare group
NPI 1275963027 (331) 221-9090

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60301 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.

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.

DR. MARK CAVALENES M.D.
Orthopaedic Surgery
1125 WESTGATE ST
OAK PARK, IL 60301
Cook County (708) 848-7700
WESTGATE ORTHOPAEDICS, LTD.
Orthopaedic Surgery
1125 WESTGATE ST
OAK PARK, IL 60301
Cook County (708) 848-7700
MARY L. KELLY, D.O., S.C.
Clinic/Center (Primary Care)
1125 WESTGATE ST
OAK PARK, IL 60301
Cook County (708) 848-0040
RIVER FOREST MEDICAL CENTER INCORPORATED
Family Medicine
1125 WESTGATE ST
OAK PARK, IL 60301
Cook County (708) 848-0040
DR. EDWARD BOONE BRACKETT III M.D.
Orthopaedic Surgery
1125 WESTGATE ST
OAK PARK, IL 60301
Cook County (708) 848-7700

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 Mary Kelly's NPI number?

The NPI number for Mary Kelly is 1912087560. It was assigned to this individual provider in the NPPES registry on October 17, 2006.

Where is Mary Kelly located?

Mary Kelly practices at 1125 Westgate St, Oak Park, IL 60301. The listed phone number is (708) 848-0040.

What is Mary Kelly's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mary Kelly enrolled in Medicare?

Yes. Mary Kelly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Kelly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Kelly reassigns Medicare benefits to Edward Health Ventures (Elmhurst, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Kelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Kelly was last updated on December 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.