Individual provider Active NPI

Marielle Mitchell, NP-C

  • Family Nurse Practitioner
  • Hoffman Estates, IL
National Provider Identifier
1063187615
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209023486 Issued in IL
Practice address
1555 Barrington Rd Ste 2550
Hoffman Estates, IL 60169-5037
Phone
(847) 250-2487
NPI assigned
Aug 14, 2021
Last updated
May 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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 209023486 IL Primary

Addresses

Primary practice location

1555 Barrington Rd Ste 2550
Hoffman Estates, IL 60169-5037

Mailing address

1555 Barrington Rd Ste 2550
Hoffman Estates, IL 60169-5037

Other practice location 1

1555 Barrington Rd Ste 2400
Bldg 3
Hoffman Estates, IL 60169-6016
Phone (847) 981-3630

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marielle.mitchell.1@380.direct.athenahealth.com

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
I20210923000430 IL Practitioner - Nurse Practitioner 4981001690 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
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

Practice addresses (Care Compare)

1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 490-6945

1555 N Barrington Rd
BLDG 1 Suite 505
Hoffman Estates, IL 60169-1099
Phone (847) 490-6960

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC CurrentSince Sep 13, 2021 Accepting new patients
Adventist Health Partners, Inc Past Accepting new patients

Locations

1555 N Barrington Rd
Ste 2400
Hoffman Estates, IL 60169
Phone (847) 981-3630

1555 N Barrington Rd
Ste 2550
Hoffman Estates, IL 60169
Phone (847) 884-7700

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412

Interoperability endpoints

  • Direct secure messaging: marielle.mitchell.1@380.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1628899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1063187615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD STE 2550",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD STE 2550",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695037",
            "telephone_number": "847-250-2487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 Barrington Rd Ste 2400",
            "address_2": "Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Hoffman Estates",
            "state": "IL",
            "postal_code": "601696016",
            "country_code": "US",
            "telephone_number": "847-981-3630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MARIELLE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-14",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marielle.mitchell.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1555 Barrington Rd Ste 2400",
            "address_2": "Bldg 3",
            "city": "Hoffman Estates",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601696016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.