Individual provider Active NPI

Nestorio Neil U Reyes

  • General Practice Registered Nurse
  • Downers Grove, IL
National Provider Identifier
1114698263
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
041.479966 Issued in IL
Practice address
3450 Saratoga Ave
Downers Grove, IL 60515-1141
Phone
(630) 969-2900
Fax
(630) 967-1964
NPI assigned
Sep 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 041.479966 IL Primary

Addresses

Primary practice location

3450 Saratoga Ave
Downers Grove, IL 60515-1141

Mailing address

3450 Saratoga Ave
Downers Grove, IL 60515-1141
Phone (630) 969-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041.479966ILMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1114698263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 SARATOGA AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151141",
            "telephone_number": "630-969-2900",
            "fax_number": "630-967-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 SARATOGA AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151141",
            "telephone_number": "630-969-2900",
            "fax_number": "630-967-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "NESTORIO NEIL",
        "middle_name": "U",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041.479966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.