Individual provider Active NPI

Nancy Slone Rivera, NP

  • Adult Health Nurse Practitioner
  • Wilmington, IL
National Provider Identifier
1083814529
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209006596 Issued in IL
Practice address
15 Hole in the Wall Rd
Wilmington, IL 60481-8772
Phone
(847) 494-3158
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Enterostomal Therapy Registered Nurse 163WE0900X 209.0065596 IL
Adult Health Nurse Practitioner 363LA2200X 209006596 IL Primary

Addresses

Primary practice location

15 Hole in the Wall Rd
Wilmington, IL 60481-8772

Mailing address

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (847) 494-3158

Other names 1

  • Mrs. Nancy Slone Other name

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
I20090826000466 IL Practitioner - Nurse Practitioner 5597810663 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Integrity Medical and Wounds Group Il RLLPGroup PAC ID 4385170612, 5 clinicians

Practice addresses (Care Compare)

8770 W Bryn Mawr Ave
Suite 1300
Chicago, IL 60631-3557
Phone (702) 258-7997

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.0065596ILMDEnterostomal Therapy Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Cross Hospital & Medical Centers CurrentSince Dec 1, 2020 Accepting new patients
Comprehensive Pathology Services, S.C. Current Accepting new patients
North Suburban Medical S.C. CurrentSince Aug 17, 2015 Accepting new patients
Integrity Medical and Wounds Group Il RLLP CurrentSince Apr 1, 2025 Accepting new patients
Lake Zurich Physical Medicine, SC PastSince Aug 17, 2015 Accepting new patients

Locations

7017 Solutions Ctr
Chicago, IL 60677

8770 W Bryn Mawr Ave
Ste 1300
Chicago, IL 60631
Phone (702) 258-7997

1800 Nations Dr
Ste 101
Gurnee, IL 60031
Phone (847) 263-0480

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

Organizations & group practices 5

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1083814529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER CROSS BLVD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604519509",
            "telephone_number": "847-494-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HOLE IN THE WALL RD",
            "city": "WILMINGTON",
            "state": "IL",
            "postal_code": "604818772",
            "telephone_number": "847-494-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "NANCY",
        "middle_name": "SLONE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0900X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Enterostomal Therapy",
            "state": "IL",
            "license": "209.0065596",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209006596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "SLONE",
            "prefix": "MRS.",
            "credential": "APN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilmington, IL

Sources for this page

Verify at the official NPI Registry.