NPIMap

Nancy J Anderson, NP

Individual provider Active NPI Adult Health Nurse Practitioner · Chicago, IL

NPI 1043445901 · NPPES record last updated May 21, 2009

Key facts

NPI
1043445901
Entity type
Individual (NPI type 1)
Primary specialty
Adult Health Nurse Practitioner 363LA2200X
License
209-007556 (IL)
Practice address
675 N Saint Clair St
Suite 21-100
Chicago, IL 60611-5975
Phone
(312) 695-0990
Fax
(312) 695-6870
NPI assigned
May 21, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty Foundation (4,386 clinicians)

Practice addresses (Care Compare)

250 E Superior
2304 Nwmff Prent WMN Hosp
Chicago, IL 60611-2914
Phone (312) 472-3660

250 E Superior St
Chicago, IL 60611-2914

4445 W Irving Park Rd
Chicago, IL 60641-2808

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital · Chicago, IL · CCN 140281
  • Palos Community Hospital Hospital · Palos Heights, IL · CCN 140062
  • Northwestern Lake Forest Hospital Hospital · Lake Forest, IL · CCN 140130
  • Northwestern Medicine Central Dupage Hospital Hospital · Winfield, IL · CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100 (apm)
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090729000854 IL Practitioner - Nurse Practitioner 6204989825 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-007556ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation Current
since Jun 9, 2009		 Accepting new patients
Northwestern Medical Faculty Foundation Current
since Jun 9, 2009		 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

250 E Superior St
#52401
Chicago, IL 60611

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

675 N Saint Clair St
Ste 21100
Chicago, IL 60611

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209-007556 IL Yes

Addresses

Primary practice location

675 N Saint Clair St
Suite 21-100
Chicago, IL 60611-5975

Mailing address

675 N Saint Clair St
Suite 21-100
Chicago, IL 60611-5975
Phone (312) 695-0990

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 21, 2009.

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242864000000",
    "number": "1043445901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST",
            "address_2": "SUITE 21-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-0990",
            "fax_number": "312-695-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST",
            "address_2": "SUITE 21-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115975",
            "telephone_number": "312-695-0990",
            "fax_number": "312-695-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-007556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

All providers in Chicago, IL · Adult Health Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.