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

Keely E Pedersen, PA-C

Individual provider Physician Assistant · NPI 1619228624

Keely E Pedersen, PA-C is a Physician Assistant in Lake Forest, Illinois. Qualified in 2009, 17 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
17
Licensed in
IL
In the registry since
2012
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

1000 N Westmoreland Rd
Lake Forest, IL 60045-1658
Phone: (847) 535-6150
Fax: (847) 535-7801
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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 085004520 (IL)

Record details

NPI number1619228624
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 1, 2012
Last updated in NPPESNovember 11, 2024
Certification dateNovember 11, 2024
Mailing address1000 N Westmoreland Rd, Lake Forest, IL 60045-1658

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Lake Forest