Active NPI
Ella Cecilia Heras
- Primary Care Nurse Practitioner
- Chicago, IL
National Provider Identifier
1205217312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 209.012808
- Practice address
- 6821 S Halsted St
Chicago, IL 60621-1833 - Phone
- (773) 651-3629
- NPI assigned
- Jun 15, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 209.012808 | IL | Primary |
Addresses
Primary practice location
6821 S Halsted St
Chicago, IL 60621-1833
Mailing address
6821 S Halsted St
Chicago, IL 60621-1833
Phone (773) 651-3629
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.012808 | IL | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beloved Community Family Wellness Center | Current | Accepting new patients | |
| Beloved Community Family Wellness Center | Current | Accepting new patients |
Locations
326 W 64th St
Ste 205
Chicago, IL 60621
Phone (773) 651-3629
6821 S Halsted St
Chicago, IL 60621
Phone (773) 651-3629
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- ella.heras.p21@direct.fhn-fqhc.nextgenshare.com
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Chicago, IL
- NPI 1760408439
-
- Federally Qualified Health Center (FQHC)
- Blue Island, IL
- NPI 1114278009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1205217312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6821 S HALSTED ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606211833",
"telephone_number": "773-651-3629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6821 S HALSTED ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606211833",
"telephone_number": "773-651-3629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERAS",
"first_name": "ELLA CECILIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-15",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "IL",
"license": "209.012808",
"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 Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.