Individual provider Active NPI

Bridget Geraghty, FNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1023639358
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017145 Issued in IL
Practice address
675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone
(312) 695-8624
Fax
(312) 695-6070
NPI assigned
Apr 27, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209017145 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980

Mailing address

675 N Saint Clair St Ste 18-250
Chicago, IL 60611-5980
Phone (312) 695-8624

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
I20201130001524 IL Practitioner - Nurse Practitioner 6305257163 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 11, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 11, 2020 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 18-250
Chicago, IL 60611
Phone (312) 695-8624

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1023639358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115980",
            "telephone_number": "312-695-8624",
            "fax_number": "312-695-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 18-250",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115980",
            "telephone_number": "312-695-8624",
            "fax_number": "312-695-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERAGHTY",
        "first_name": "BRIDGET",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.