Individual provider Active NPI

Rebecca Gloria Shah, APN-CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1164129458
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027158 Issued in IL
Practice address
1715 E 95TH St
Chicago, IL 60617-4708
Phone
(773) 977-7256
NPI assigned
Feb 8, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 209.027158 IL
Registered Nurse 163W00000X 041459161 IL
Nurse Practitioner 363L00000X 209027158 IL Primary

Addresses

Primary practice location

1715 E 95TH St
Chicago, IL 60617-4708

Mailing address

PO Box 1541
Northbrook, IL 60065-1541
Phone (847) 386-7744

Other practice location 1

1777 Green Bay Rd Ste 201
Highland Park, IL 60035-3109
Phone (847) 433-3460

Other names 1

  • Rebecca Gloria Bernardi Former name

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
I20230426002741 IL Practitioner - Nurse Practitioner 6507221512 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1777 Green Bay Rd
Suite 201
Highland Park, IL 60035-3109
Phone (847) 433-3460

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041459161ILMDRegistered Nurse
209027158ILMDNurse Practitioner
209.027158ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Oct 21, 2024 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 10, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jun 10, 2024 Accepting new patients
Oak Street Health Physicians Group, PC Nurse Practitioner CurrentSince Apr 14, 2023 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

676 N Saint Clair St
Ste 2030
Chicago, IL 60611
Phone (312) 926-6831

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

1715 E 95th St
Chicago, IL 60617
Phone (773) 768-4437

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

1777 Green Bay Rd
Highland Park, IL 60035
Phone (847) 433-3460

1777 Green Bay Rd
#201
Highland Park, IL 60035
Phone (847) 433-3460

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1164129458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1541",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600651541",
            "telephone_number": "847-386-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174708",
            "telephone_number": "773-977-7256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1777 Green Bay Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "IL",
            "postal_code": "600353109",
            "country_code": "US",
            "telephone_number": "847-433-3460",
            "fax_number": "847-433-4062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "REBECCA",
        "middle_name": "GLORIA",
        "credential": "APN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-08",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.027158",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041459161",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BERNARDI",
            "middle_name": "GLORIA",
            "credential": "APN-CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.