Individual provider Active NPI

Maria Andreea Bordeianu, FPA-APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Niles, IL
National Provider Identifier
1114549755
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277002341 Issued in IL
Practice address
7800 N Milwaukee Ave
Niles, IL 60714-3124
Phone
(312) 809-0777
Fax
(773) 492-8783
NPI assigned
May 16, 2020
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277002341 IL Primary
Assistant Behavior Analyst 106E00000X NU

Addresses

Primary practice location

7800 N Milwaukee Ave
Niles, IL 60714-3124

Mailing address

6050 N California Ave Ste 101
Chicago, IL 60659-3916
Phone (773) 406-2866

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
I20210222001999 IL Practitioner - Nurse Practitioner 9830504042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7800 N Milwaukee Ave
Niles, IL 60714-3124
Phone (773) 406-2866

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Mantis Care CurrentSince Dec 1, 2020 Accepting new patients

Locations

6050 N California Ave
Chicago, IL 60659
Phone (847) 675-6093

6050 N California Ave
Ste 101
Chicago, IL 60659
Phone (312) 809-0777

7800 N Milwaukee Ave
Niles, IL 60714
Phone (312) 809-0777

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1589587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1114549755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6050 N CALIFORNIA AVE STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593916",
            "telephone_number": "773-406-2866",
            "fax_number": "847-675-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143124",
            "telephone_number": "312-809-0777",
            "fax_number": "773-492-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEIANU",
        "first_name": "MARIA",
        "middle_name": "ANDREEA",
        "name_prefix": "Dr.",
        "credential": "FPA-APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-16",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277002341",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.