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

Dr. Derek Joseph Kelly, MD

Individual provider Family Medicine Physician · NPI 1407989106

Dr. Derek Joseph Kelly, MD is a Family Practice in Evanston, Illinois. Qualified in 1978, 48 years ago. Accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
48
Licensed in
IL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

800 Austin St Ste 157
Evanston, IL 60202-3452
Phone: (773) 293-3510
Fax: (773) 293-3514
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036063365 (IL)

Record details

NPI number1407989106
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 13, 2007
Last updated in NPPESJanuary 29, 2026
Certification dateJanuary 29, 2026

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1978 (48 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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