Kelsey M Bacidore, MD
Emergency Medicine in Maywood, IL. Individual provider (NPI-1).
NPI number1932858230
StatusActive
Last updated in NPPESAug 17, 2026
Details
- NPI
- 1932858230
- Entity type
- Individual (NPI-1)
- Name
- Kelsey M Bacidore
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2022
- Certification date
- Aug 17, 2026
- Last updated
- Aug 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 036172511 | IL | Yes |
| 207P00000X | Emergency Medicine | 125.080549 | IL |
Other names
- Kelsey Marie Johnson (Other Name)
Practice location
2160 S 1st AveMaywood, IL 60153-3328
Phone 888-584-7888
Mailing address
2160 S 1st AveMaywood, IL 60153-3328
Other practice locations
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Dekalb, IL 60115-9602
Phone 815-766-7334 · Fax 815-766-9768
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