Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Kaminke, PA-C

Individual provider Physician Assistant · NPI 1548741945

Carly Kaminke, PA-C is a Physician Assistant in Bourbonnais, Illinois. Graduated from Lincoln Memorial University Medical Department in 2018, 8 years ago. Practices with Riverside Health System, a 205-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Trained at
Lincoln Memorial University Medical Department
Licensed in
IL
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

400 Riverside Dr Ste 1600
Bourbonnais, IL 60914-5406
Phone: (815) 802-7090
Fax: (815) 802-7091
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085006802 (IL)

Record details

NPI number1548741945
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 23, 2018
Last updated in NPPESMarch 22, 2021
Certification dateMarch 22, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2018 (8 years in practice)
Group practice Riverside Health System — 205 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Bourbonnais