Kelly Shi Thao, MD in Park Ridge, IL - Medicare Family Practice

Kelly Shi Thao, MD is a medicare enrolled "Family Medicine" physician in Park Ridge, Illinois. She graduated from medical school in 2022 and has 4 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Fairview Clinics, Healtheast Medical Research Institute and her current practice location is 1775 Dempster St, Park Ridge, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 318-2710.

Kelly Shi Thao is licensed to practice in Minnesota (license number 77739) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1588307441.

Contact Information

	Kelly Shi Thao, MD
	1775 Dempster St, Park Ridge, IL 60068-1143
	(847) 318-2710
	Not Available

Map and Direction

Physician's Profile

Full Name	Kelly Shi Thao
Gender	Female
Speciality	Family Practice
Experience	4 Years
Location	1775 Dempster St, Park Ridge, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kelly Shi Thao graduated from medical school in 2022

NPI Data:

NPI Number: 1588307441
Provider Enumeration Date: 04/19/2022
Last Update Date: 04/09/2026

Medicare PECOS Information:

PECOS PAC ID: 1557740107
Enrollment ID: I20250226001197

Medical Identifiers

Medical identifiers for Kelly Shi Thao such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588307441	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	77739 (Minnesota)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Healtheast St John's Hospital	Maplewood, MN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fairview Clinics	7113830142	813
Healtheast Medical Research Institute	3971407636	692

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelly Shi Thao allows following entities to bill medicare on her behalf.

Entity Name	Fairview Clinics
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346432218 PECOS PAC ID: 7113830142 Enrollment ID: O20031106000516

Entity Name	Healtheast Medical Research Institute
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639125503 PECOS PAC ID: 3971407636 Enrollment ID: O20031124000507

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Shi Thao is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kelly Shi Thao, MD 1775 Dempster St, Park Ridge, IL 60068-1143 Ph: (847) 723-2210	Kelly Shi Thao, MD 1775 Dempster St, Park Ridge, IL 60068-1143 Ph: (847) 318-2710

Reviews and Comments

Family Medicine Doctors in Park Ridge, IL

Rachel Reshmi George, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1775 Ballard Rd Fl 2, Park Ridge, IL 60068 Phone: 847-318-6020
Dr. Dimitrina Vizinas, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1440 Renaissance Dr Ste 300, Park Ridge, IL 60068 Phone: 847-254-9714 Fax: 847-803-1806
Michael K Prochazka, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1775 Ballard Rd Fl 2, Park Ridge, IL 60068 Phone: 847-318-6020
Dr. Agnieszka Kania, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1875 Dempster St, 506, Park Ridge, IL 60068 Phone: 847-593-6600
Izabela Ana Pop, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1775 Ballard Rd Fl 2, Park Ridge, IL 60068 Phone: 847-318-6020
Dr. Maureen E Grosdidier, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 850 Busse Hwy, Park Ridge, IL 60068 Phone: 847-825-0300 Fax: 847-825-1825
Stuart Lewis Goldman, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1775 Ballard Rd, Park Ridge, IL 60068 Phone: 847-318-6020 Fax: 847-318-2712

Kelly Shi Thao, MD - Medicare Family Practice in Park Ridge, IL