Individual provider Active NPI

Merilyn Rivera, FNP-C

  • Primary Care Nurse Practitioner
  • Addison, IL
National Provider Identifier
1073403713
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209.032662 Issued in IL
Practice address
228 E Lake St
Addison, IL 60101-2889
Phone
(630) 835-1430
NPI assigned
Jul 5, 2025
Last updated
Jul 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209.032662 IL Primary

Addresses

Primary practice location

228 E Lake St
Addison, IL 60101-2889

Mailing address

4429 N Kildare Ave # 4G
Chicago, IL 60630-4290
Phone (915) 258-7006

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
I20250918003275 IL Practitioner - Nurse Practitioner 4981108222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamdard Health AllianceGroup PAC ID 4880680289, 18 clinicians

Practice addresses (Care Compare)

1542 W Devon Ave
Chicago, IL 60660-1344
Phone (630) 835-1430

228 E Lake St
Addison, IL 60101-2889
Phone (630) 835-1430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.032662ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamdard Health Alliance CurrentSince Aug 13, 2025 Accepting new patients
Hamdard Health Alliance CurrentSince Aug 13, 2025 Accepting new patients
Hamdard Health Alliance Past Accepting new patients

Locations

228 E Lake St
Addison, IL 60101
Phone (630) 835-1430

1542 W Devon Ave
Chicago, IL 60660
Phone (773) 465-4600

Interoperability endpoints

  • Direct secure messaging: merilyn.rivera.1@10099.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1751673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1073403713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 N KILDARE AVE # 4G",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606304290",
            "telephone_number": "915-258-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 E LAKE ST",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012889",
            "telephone_number": "630-835-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MERILYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-05",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.032662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

Verify at the official NPI Registry.