Individual provider Active NPI

Danielle Solares, DNP, FNP-C

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1013509660
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209022410 Issued in IL
Practice address
3413 Colony Bay Dr
Rockford, IL 61109-2560
Phone
(779) 368-0757
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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 209022410 IL Primary

Addresses

Primary practice location

3413 Colony Bay Dr
Rockford, IL 61109-2560

Mailing address

5333 Jackies CT
Loves Park, IL 61111-3446
Phone (815) 494-4219

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
I20221130002135 IL Order and Referring Only - Nurse Practitioner 8224406988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Everside Health, LLC PastSince Feb 7, 2021 Accepting new patients

Organizations & group practices 1

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": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1013509660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 JACKIES CT",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113446",
            "telephone_number": "815-494-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 COLONY BAY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092560",
            "telephone_number": "779-368-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLARES",
        "first_name": "DANIELLE",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.