Active NPI
Magaly Nickles, APN
- Nurse Practitioner
- McHenry, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209010594
- Practice address
- 4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418 - Phone
- (847) 802-7400
- NPI assigned
- Aug 26, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 041337837 | IL | |
| Nurse Practitioner | 363L00000X | 209010594 | IL | Primary |
Addresses
Primary practice location
4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418
Mailing address
4309 W Medical Center Dr Ste B305
McHenry, IL 60050-8418
Phone (847) 802-7400
Other practice location 1
10350 Haligus Rd Ste C
Huntley, IL 60142-9545
Phone (847) 802-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209-010594 | Other | IL | LICENSE NUMBER |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4201 W Medical Ctr Dr
McHenry, IL 60050-8409
Phone (815) 759-4323
4309 W Medical Ctr Dr
Suite A201
McHenry, IL 60050-8411
Phone (815) 759-8070
515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
Hospital & facility affiliations
- Northwestern Medicine McHenry
- Northwestern Lake Forest Hospital
- Northwestern Medicine Central Dupage Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041337837 | IL | MD | Nurse Practitioner |
| 209010594 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
10350 Haligus Rd
Ste C
Huntley, IL 60142
Phone (312) 695-3800
11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
4309 W Medical Center Dr
Ste B301
McHenry, IL 60050
Phone (847) 535-6083
4309 W Medical Center Dr
Ste B305
McHenry, IL 60050
Phone (847) 802-7400
4309 W Medical Center Dr
Ste A102
McHenry, IL 60050
Phone (815) 759-4323
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- General Acute Care Hospital
- McHenry, IL
- NPI 1982611281
-
- General Acute Care Hospital
- Lake Forest, IL
- NPI 1124025176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1033543129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4309 W MEDICAL CENTER DR STE B305",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508418",
"telephone_number": "847-802-7400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4309 W MEDICAL CENTER DR STE B305",
"city": "MCHENRY",
"state": "IL",
"postal_code": "600508418",
"telephone_number": "847-802-7400"
}
],
"practiceLocations": [
{
"address_1": "10350 Haligus Rd Ste C",
"address_purpose": "LOCATION",
"city": "Huntley",
"state": "IL",
"postal_code": "601429545",
"country_code": "US",
"telephone_number": "847-802-7400",
"fax_number": "847-802-7399",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NICKLES",
"first_name": "MAGALY",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-26",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "041337837",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209010594",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "209-010594",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in McHenry, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.