Individual provider Active NPI

Rebecca Stealey, APRN

  • Gerontology Nurse Practitioner
  • Burr Ridge, IL
National Provider Identifier
1194331827
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
309019076 Issued in IL
Practice address
11S250 S Jackson St Ste 101
Burr Ridge, IL 60527-6884
Phone
(630) 321-9010
Fax
(630) 321-9018
NPI assigned
Sep 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WX0200X 041418727 IL
Gerontology Nurse Practitioner 363LG0600X 309019076 IL Primary

Addresses

Primary practice location

11S250 S Jackson St Ste 101
Burr Ridge, IL 60527-6884

Mailing address

11S250 S Jackson St Ste 101
Burr Ridge, IL 60527-6884
Phone (630) 321-9010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 23, 2022 through Aug 23, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041418727ILMDOncology Registered Nurse
309019076ILMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1194331827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11S250 S JACKSON ST STE 101",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276884",
            "telephone_number": "630-321-9010",
            "fax_number": "630-321-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11S250 S JACKSON ST STE 101",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605276884",
            "telephone_number": "630-321-9010",
            "fax_number": "630-321-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEALEY",
        "first_name": "REBECCA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2023-06-08",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Oncology",
            "state": "IL",
            "license": "041418727",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "309019076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.