Individual provider Active NPI

Maira Ochoa, APN

  • Family Nurse Practitioner
  • Harvey, IL
National Provider Identifier
1003303769
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.017480 Issued in IL
Practice address
31 W 155TH St
Harvey, IL 60426-3556
Phone
(708) 596-5177
Fax
(708) 596-5518
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.017480 IL Primary

Addresses

Primary practice location

31 W 155TH St
Harvey, IL 60426-3556

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177

Other practice location 1

19767 Torrence Ave
Lynwood, IL 60411-7624
Phone (708) 596-5177

Other practice location 2

713 E 142nd St
Dolton, IL 60419-1062
Phone (708) 596-5518

Other practice location 3

15620 Wood St
Harvey, IL 60426-4171
Phone (708) 596-5177

Other identifiers 1

IdentifierTypeStateIssuer
209.017480OtherILADVANCED PRACTICE NURSE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180702001883 IL Practitioner - Nurse Practitioner 4688920838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.017480ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Christian Health Center CurrentSince May 9, 2018 Accepting new patients
Family Christian Health Center CurrentSince May 9, 2018 Accepting new patients
Family Christian Health Center Current Accepting new patients
Family Christian Health Center Past Accepting new patients
Family Christian Health Center Past Accepting new patients

Locations

713 E 142nd St
Dolton, IL 60419
Phone (708) 596-5177

31 W 155th St
Harvey, IL 60426
Phone (708) 596-5177

15620 Wood St
Harvey, IL 60426
Phone (708) 333-3030

19767 Torrence Ave
Lynwood, IL 60411
Phone 7085965177 ext. 8793

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1003303769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-589-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19767 Torrence Ave",
            "address_purpose": "LOCATION",
            "city": "Lynwood",
            "state": "IL",
            "postal_code": "604117624",
            "country_code": "US",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "713 E 142nd St",
            "address_purpose": "LOCATION",
            "city": "Dolton",
            "state": "IL",
            "postal_code": "604191062",
            "country_code": "US",
            "telephone_number": "708-596-5518",
            "fax_number": "708-596-5518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15620 Wood St",
            "address_purpose": "LOCATION",
            "city": "Harvey",
            "state": "IL",
            "postal_code": "604264171",
            "country_code": "US",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCHOA",
        "first_name": "MAIRA",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE LICENSE",
            "identifier": "209.017480",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.