Individual provider Active NPI

Brandon Barrios

  • Family Nurse Practitioner
  • Waukegan, IL
National Provider Identifier
1073318358
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.032032 Issued in IL
Practice address
3010 Grand Ave
Waukegan, IL 60085-2321
Phone
(847) 377-8800
NPI assigned
Feb 19, 2025
Last updated
Jul 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16510-33 WI
Family Nurse Practitioner 363LF0000X 209.032032 IL Primary

Addresses

Primary practice location

3010 Grand Ave
Waukegan, IL 60085-2321

Mailing address

1615 Carmel Blvd
Zion, IL 60099-3630
Phone (224) 717-6587

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
I20250923002336 IL Practitioner - Nurse Practitioner 5698270510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LakeGroup PAC ID 7214838861, 42 clinicians

Practice addresses (Care Compare)

2215 Audrey Nixon Blvd
North Chicago, IL 60064-1618
Phone (847) 377-8800

2400 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8800

2410 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.032032ILMDFamily Nurse Practitioner
16510-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake Current Accepting new patients
County of Lake CurrentSince May 25, 2025 Accepting new patients
County of Lake CurrentSince May 25, 2025 Accepting new patients
County of Lake Past Accepting new patients

Locations

2215 Audrey Nixon Blvd
North Chicago, IL 60064
Phone (847) 377-8800

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: brandon.barrios.p1@direct.lakecountyil.nextgenshare.com

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

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1073318358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 CARMEL BLVD",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600993630",
            "telephone_number": "224-717-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "847-377-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRIOS",
        "first_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "16510-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.032032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.