Individual provider Active NPI

Jinan Shetaya, FNP

  • Family Nurse Practitioner
  • Matteson, IL
National Provider Identifier
1003771122
Registry record updated Dec 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209033990 Issued in IL
Practice address
402 Town Center Rd
Matteson, IL 60443-2300
Phone
(708) 852-5179
NPI assigned
Dec 20, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2025

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 209033990 IL Primary

Addresses

Primary practice location

402 Town Center Rd
Matteson, IL 60443-2300

Mailing address

16430 Olde Gatehouse Rd
Tinley Park, IL 60477-6857
Phone (708) 737-5472

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
I20260129000826 IL Practitioner - Nurse Practitioner 0840778197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209033990ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Dec 30, 2025 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Dec 30, 2025 Accepting new patients

Locations

402 Town Center Rd
Matteson, IL 60443
Phone (708) 843-1877

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 2

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": "1766188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766188800000",
    "number": "1003771122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16430 OLDE GATEHOUSE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776857",
            "telephone_number": "708-737-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 TOWN CENTER RD",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604432300",
            "telephone_number": "708-852-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETAYA",
        "first_name": "JINAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-20",
        "last_updated": "2025-12-20",
        "certification_date": "2025-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209033990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

Verify at the official NPI Registry.