Individual provider Active NPI

Gregory Robert Cook Jr., APRN, CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1053964395
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027656 Issued in IL
Practice address
676 N Saint Clair St Ste 2100
Chicago, IL 60611-2993
Phone
(312) 695-1800
Fax
(312) 695-4741
NPI assigned
Jul 16, 2019
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209027656 IL Primary
Family Nurse Practitioner 363LF0000X 11003002 FL

Addresses

Primary practice location

676 N Saint Clair St Ste 2100
Chicago, IL 60611-2993

Mailing address

676 N Saint Clair St Ste 2100
Chicago, IL 60611-2993
Phone (312) 695-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.myhealth.va.gov Department of Veterans Affairs

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201007002261 FL Practitioner - Nurse Practitioner 4688093826
I20230918004215 IL Practitioner - Nurse Practitioner 4688093826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

676 N Saint Clair
Chicago, IL 60611-2927

676 N Saint Clair St
Chicago, IL 60611-2927

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003002FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 6, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 6, 2023 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 2100
Chicago, IL 60611
Phone (312) 695-3117

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1053964395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112993",
            "telephone_number": "312-695-1800",
            "fax_number": "312-695-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 2100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112993",
            "telephone_number": "312-695-1800",
            "fax_number": "312-695-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "GREGORY",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027656",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.myhealth.va.gov",
            "affiliation": "Y",
            "affiliationName": "Department of Veterans Affairs",
            "address_1": "1536 N Jefferson St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322096525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.