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

MS. Kathryn Ilissa Ross, PA-C

Individual provider Registered Dietitian · NPI 1124434014

MS. Kathryn Ilissa Ross, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2018, 8 years ago. Practices with Rockford Psychiatric Medical Services SC, a 151-clinician group and accepts Medicare assignment. Licensed in Illinois and Pennsylvania.

Years since qualifying
8
Licensed in
IL, PA
In the registry since
2014
Specialties on file
3
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

259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone: (312) 695-5620
Fax: (312) 695-2310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (IL)
Registered Dietitian Taxonomy 133V00000X · Licence DN004758 (PA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 085006742 (IL)

Record details

NPI number1124434014
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 11, 2014
Last updated in NPPESJuly 11, 2023
Certification dateJuly 11, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Rockford Psychiatric Medical Services Sc — 151 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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