Individual provider Active NPI

Bailey R Hanselman, DNP, APRN, FNP-C

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1083357537
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209025490 Issued in IL
Practice address
259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone
(312) 695-5620
Fax
(312) 695-2778
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
Yes

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.025490 IL
Nurse Practitioner 363L00000X 209025490 IL Primary
Gastroenterology Registered Nurse 163WG0100X 041451153 IL

Addresses

Primary practice location

259 E Erie St Ste 1600
Chicago, IL 60611-3111

Mailing address

259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone (312) 695-5620

Other identifiers 1

IdentifierTypeStateIssuer
12345OtherILUIC

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL uic.edu Direct

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
I20220916000087 IL Practitioner - Nurse Practitioner 2668857368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1630 Sherman Ave
Evanston, IL 60201-3711

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

4445 W Irving Park Rd
Chicago, IL 60641-2808

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041451153ILMDGastroenterology Registered Nurse
209025490ILMDNurse Practitioner
209.025490ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc CurrentSince Jul 13, 2022 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 10, 2023 Accepting new patients
Erie Family Health Center Inc CurrentSince Jul 13, 2022 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 10, 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

836 W Wellington Ave
Chicago, IL 60657
Phone (773) 296-7054

1504 S Albany Ave
Chicago, IL 60623

4747 N Kedzie Ave
Chicago, IL 60625

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

259 E Erie St
Ste 1600
Chicago, IL 60611

1630 Sherman Ave
Ste 100
Evanston, IL 60201
Phone (224) 271-4860

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 6

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.

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": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1083357537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-5620",
            "fax_number": "312-695-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-5620",
            "fax_number": "312-695-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSELMAN",
        "first_name": "BAILEY",
        "middle_name": "R",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025490",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209025490",
            "primary": true
        },
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "IL",
            "license": "041451153",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIC",
            "identifier": "12345",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "uic.edu",
            "affiliation": "N",
            "endpointDescription": "uic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "uic",
            "address_1": "836 W Wellington Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.