Individual provider Active NPI

Guadalupe Rodriguez, APRN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1104301746
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018548 Issued in IL
Practice address
635 N Dearborn St Ste 100
Chicago, IL 60654-4618
Phone
(312) 694-2273
Fax
(312) 694-2129
NPI assigned
Sep 29, 2018
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209018548 IL Primary

Addresses

Primary practice location

635 N Dearborn St Ste 100
Chicago, IL 60654-4618

Mailing address

635 N Dearborn St Ste 100
Chicago, IL 60654-4618
Phone (312) 694-2273

Other practice location 1

3471 Green Bay Rd
North Chicago, IL 60064-3090
Phone (847) 578-8846

Other practice location 2

3471 Green Bay Rd
North Chicago, IL 60064-3090
Phone (847) 578-8846

Other practice location 3

375 Bedford Ct
Park City, IL 60085-4756
Phone (224) 399-7789

Other identifiers 1

IdentifierTypeStateIssuer
209018548OtherILSTATE OF IL

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
I20190820001927 IL Practitioner - Nurse Practitioner 5991033649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sapphire Health and Wellness PLLC Current Accepting new patients
Central Dupage Physician Group PastSince Apr 3, 2022 Accepting new patients

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": "1538179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1104301746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N DEARBORN ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544618",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N DEARBORN ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544618",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3471 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600643090",
            "country_code": "US",
            "telephone_number": "847-578-8846",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3471 Green Bay Rd",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600643090",
            "country_code": "US",
            "telephone_number": "847-578-8846",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "375 Bedford Ct",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "IL",
            "postal_code": "600854756",
            "country_code": "US",
            "telephone_number": "224-399-7789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GUADALUPE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-29",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL",
            "identifier": "209018548",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.