Individual provider Active NPI

Vanessa Elizabeth Galloway, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1114634805
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.026292 Issued in IL
Practice address
9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone
(708) 422-7715
NPI assigned
Nov 1, 2022
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 209.026292 IL Primary

Addresses

Primary practice location

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441

Mailing address

120 W 22ND St
Oak Brook, IL 60523-1557
Phone (630) 573-5000

Other practice location 1

9977 Woods Dr
Skokie, IL 60077-1057
Phone (224) 364-2273

Other practice location 2

16605 S 107th Court
Orland Park, IL 60467
Phone (708) 226-9860

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
I20221121000759 IL Practitioner - Nurse Practitioner 4587032735 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
Group practices
Southwest Nephrology Associates, S.C.Group PAC ID 1557335460, 13 clinicians

Practice addresses (Care Compare)

16605 107TH St
Orland Park, IL 60467-9016
Phone (708) 226-9860

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone (708) 422-7715

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209.026292ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Nephrology Associates, S.C. CurrentSince Jul 1, 2024 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. CurrentSince Jun 1, 2024 Accepting new patients

Locations

12250 S Cicero Ave
Ste 112
Alsip, IL 60803
Phone (708) 371-5308

3223 W 63rd St
Chicago, IL 60629
Phone (773) 735-4884

800 Biesterfield Rd
Ste 104
Elk Grove Village, IL 60007
Phone (847) 593-9182

9125 S Pulaski Rd
Evergreen Pk, IL 60805
Phone (708) 422-7715

120 W 22nd St
Oak Brook, IL 60523

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

16605 107th St
Orland Park, IL 60467
Phone (708) 226-9860

Interoperability endpoints

  • Direct secure messaging: vgalloway64917@direct.acumenmd.com

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": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1114634805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051441",
            "telephone_number": "708-422-7715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9977 Woods Dr",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "600771057",
            "country_code": "US",
            "telephone_number": "224-364-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16605 S 107th Court",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "60467",
            "country_code": "US",
            "telephone_number": "708-226-9860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLOWAY",
        "first_name": "VANESSA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.026292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.