Individual provider Active NPI

Arvie Calabazaron, AGNP-C

  • Nurse Practitioner
  • Schaumburg, IL
National Provider Identifier
1104362755
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209015272 Issued in IL
Practice address
1355 Remington Rd
Suite H
Schaumburg, IL 60173-4832
Phone
(630) 701-9009
NPI assigned
Jan 6, 2017
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209015272 IL Primary

Addresses

Primary practice location

1355 Remington Rd
Suite H
Schaumburg, IL 60173-4832

Mailing address

1355 Remington Rd
Suite H
Schaumburg, IL 60173-4832
Phone (630) 701-9009

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
I20170113000041 IL Practitioner - Nurse Practitioner 5496037145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Illinois LLCGroup PAC ID 2264747344, 38 clinicians

Practice addresses (Care Compare)

1530 N Randall Rd
Suite 210
Elgin, IL 60123-7879
Phone (224) 760-7322

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015272ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Home Doctors Medical Practice PLLC CurrentSince May 1, 2021 Accepting new patients
Chestnut Health of Illinois LLC CurrentSince Apr 1, 2022 Accepting new patients

Locations

1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322

1901 N Roselle Rd
Ste 800
Schaumburg, IL 60195
Phone (847) 220-7603

1901 N Roselle Rd
Ste 822D
Schaumburg, IL 60195
Phone (847) 908-3471

Organizations & group practices 2

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": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1104362755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "address_2": "SUITE H",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734832",
            "telephone_number": "630-701-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "address_2": "SUITE H",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734832",
            "telephone_number": "630-701-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALABAZARON",
        "first_name": "ARVIE",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.