Annabella Vidal-Ruiz, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209014250 Issued in IL

Practice address

1431 N Western Ave Ste 306
Chicago, IL 60622-1775

Phone

(312) 445-0995

NPI assigned

May 1, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Clear Minds Better Lives PC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1275056897
  Medicare reassignment NPD Authorized official
• Presence Healthcare Services

  • Multi-Specialty Clinic/Center
  • Elk Grove Village, IL
  • NPI 1932216819
  Medicare reassignment NPD
• Presence Healthcare Services

  • Internal Medicine Physician
  • Bolingbrook, IL
  • NPI 1043748338
  NPD
• Resurrection Services

  • Hematology & Oncology Physician
  • Chicago, IL
  • NPI 1356647960
  NPD
• Glaser and Associates LLC

  • Psychiatry Physician
  • Chicago, IL
  • NPI 1326567058
  NPD (past)

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

{
    "created_epoch": "1462060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1063867760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606470005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 306",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221775",
            "telephone_number": "312-445-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL-RUIZ",
        "first_name": "ANNABELLA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-01",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209014250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vida Medical Centers PLLC
• Vida Pediatrics, LTD.
• Vida Therapy
• Gabriel Ernest Vida, DDS
• Vidal Therapy PLLC
• Daniela Michelle Vidal, LCSW
• Elisa Vidal, PHARMD
• Patricia Vidal, M.D.
• Rachel W Vidal, MD
• Theresa Marie Vidalon, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.

Verify at the official NPI Registry.