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

Kendra Ann Pauley

Individual provider Registered Nurse · NPI 1720792617

Kendra Ann Pauley is a Nurse Practitioner in Kankakee, Illinois. Qualified in 2022, 4 years ago. Practices with Riverside Health System, a 205-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
4
Licensed in
IL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

375 N Wall St Ste P510
Kankakee, IL 60901-3492
Phone: (815) 935-0750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 350 N Wall St, Kankakee, IL 60901-2901 — (815) 933-1671

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209027052 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 041454399 (IL)

Record details

NPI number1720792617
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 6, 2023
Last updated in NPPESMay 4, 2023
Certification dateMay 4, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Riverside Health System — 205 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Kankakee