Individual provider Active NPI

Silvija Rezo, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Northbrook, IL
National Provider Identifier
1144730904
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015408 Issued in IL
Practice address
936 Willow Rd
Northbrook, IL 60062-6822
Phone
(708) 269-6674
NPI assigned
Oct 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 209015408 IL Primary

Addresses

Primary practice location

936 Willow Rd
Northbrook, IL 60062-6822

Mailing address

346 Park Dr
Northbrook, IL 60062-4813

Other practice location 1

346 Park Dr
Northbrook, IL 60062-4813
Phone (773) 742-0225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180124000421 IL Practitioner - Nurse Practitioner 8628337466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.08 of 100Reported as group
Quality
82.62
Improvement activities
40
Cost
78.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209015408ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince Dec 28, 2017 Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

520 N Western Ave
Lake Forest, IL 60045
Phone (847) 739-3111

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

936 Willow Rd
Northbrook, IL 60062
Phone (847) 239-8447

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1144730904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 PARK DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600624813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 WILLOW RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626822",
            "telephone_number": "708-269-6674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "346 Park Dr",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600624813",
            "country_code": "US",
            "telephone_number": "773-742-0225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZO",
        "first_name": "SILVIJA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.