Individual provider Active NPI

Karina Quinto Vazquez, FNP-C

  • Family Nurse Practitioner
  • Champaign, IL
National Provider Identifier
1134856412
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209025089 Issued in IL
Practice address
2718 N Prospect Ave
Champaign, IL 61822-1298
Phone
(217) 337-3852
NPI assigned
Aug 5, 2022
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 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 PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 209025089 IL Primary

Addresses

Primary practice location

2718 N Prospect Ave
Champaign, IL 61822-1298

Mailing address

1006 Cambridge Dr
Rantoul, IL 61866-1202
Phone (217) 390-1479

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
I20220930000550 IL Practitioner - Nurse Practitioner 7810373750 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 563-4270

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209025089ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Multi-Specialty CurrentSince Jun 3, 2024 Accepting new patients
Rush Oak Park ER Physicians Group Multi-Specialty CurrentSince Jun 3, 2024 Accepting new patients
Cook County Multi-Specialty Current Accepting new patients
Rush University Medical Center Multi-Specialty CurrentSince Jun 3, 2024 Accepting new patients
Cook County Multi-Specialty CurrentSince Sep 15, 2024 Accepting new patients
Cook County CurrentSince Sep 15, 2024 Accepting new patients

Locations

1625 N Harlem Ave
Chicago, IL 60707
Phone (708) 312-0360

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

75 Remittance Dr
Dept 1611
Chicago, IL 60675

75 Remittance Dr
Dept 1620
Chicago, IL 60675

520 S Maple Ave
Oak Park, IL 60304
Phone (708) 383-9300

Organizations & group practices 6

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 3

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": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1134856412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 CAMBRIDGE DR",
            "city": "RANTOUL",
            "state": "IL",
            "postal_code": "618661202",
            "telephone_number": "217-390-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221298",
            "telephone_number": "217-337-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTO VAZQUEZ",
        "first_name": "KARINA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.