Individual provider Active NPI

Jennifer Marie Nieves, APN

  • Women's Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1154959864
Registry record updated Mar 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209020582 Issued in IL
Practice address
34 E Oak St Ste 6
Chicago, IL 60611-1231
Phone
(773) 550-5475
NPI assigned
Mar 29, 2020
Last updated
Mar 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209020582 IL Primary

Addresses

Primary practice location

34 E Oak St Ste 6
Chicago, IL 60611-1231

Mailing address

3133 S Wallace St Unit 1
Chicago, IL 60616-3028
Phone (773) 550-5475

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
209020582ILMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585440000000",
    "number": "1154959864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 S WALLACE ST UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163028",
            "telephone_number": "773-550-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 E OAK ST STE 6",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606111231",
            "telephone_number": "773-550-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-29",
        "last_updated": "2020-03-29",
        "certification_date": "2020-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209020582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; 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.