Individual provider Active NPI

Soledad Rios

  • Family Nurse Practitioner
  • Grayslake, IL
National Provider Identifier
1194100446
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277000941 Issued in IL
Practice address
32908 N John Mogg Rd
Grayslake, IL 60030-2234
Phone
(224) 305-2739
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209012982 IL
Family Nurse Practitioner 363LF0000X 277000941 IL Primary

Addresses

Primary practice location

32908 N John Mogg Rd
Grayslake, IL 60030-2234

Mailing address

32908 N John Mogg Rd
Grayslake, IL 60030-2234
Phone (224) 305-2739

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
I20151112000662 IL Practitioner - Nurse Practitioner 3274843701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians

Practice addresses (Care Compare)

2323 Grand Ave
Waukegan, IL 60085-3312
Phone (847) 666-3494

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277000941ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Nov 30, 2015 Accepting new patients
Erie Family Health Center Inc. CurrentSince Nov 30, 2015 Accepting new patients

Locations

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

2323 Grand Ave
Waukegan, IL 60085
Phone (847) 666-2427

Interoperability endpoints

  • Direct secure messaging: srios368785@direct.ochin.org

Organizations & group practices 3

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 1

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": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1194100446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32908 N JOHN MOGG RD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302234",
            "telephone_number": "224-305-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32908 N JOHN MOGG RD",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600302234",
            "telephone_number": "224-305-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "SOLEDAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012982",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.