Individual provider Active NPI

Jenice Lopez, FNP-C

  • Family Nurse Practitioner
  • Des Plaines, IL
National Provider Identifier
1205440948
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021901 Issued in IL
Practice address
77 Rand Rd
Des Plaines, IL 60016-1005
Phone
(847) 296-3040
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-021901 IL
Family Nurse Practitioner 363LF0000X 209021901 IL Primary

Addresses

Primary practice location

77 Rand Rd
Des Plaines, IL 60016-1005

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

101 S Northwest Hwy
Barrington, IL 60010-4607
Phone (847) 381-4105

Other practice location 2

936 Willow Rd
Northbrook, IL 60062-6822
Phone (847) 668-3522

Other practice location 3

15 N Buffalo Grove Rd
Buffalo Grove, IL 60089
Phone (800) 225-0394

Electronic endpoints 4

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address jlopez368031@direct.myadvocateaurora.org Direct
Direct Messaging Address jlopez368031@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20201207002379 IL Practitioner - Nurse Practitioner 1456763986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

77 Rand Rd
Des Plaines, IL 60016-1005
Phone (847) 294-5490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209-021901ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Mar 24, 2023 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Midwest Home Physicians Inc CurrentSince Oct 6, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 24, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

15 N Buffalo Grove Rd
Buffalo Grove, IL 60089
Phone (847) 520-7080

29373 Network Pl
Chicago, IL 60673

77 Rand Rd
Des Plaines, IL 60016
Phone (847) 294-5490

6421 N Hamlin Ave
Ste F
Lincolnwood, IL 60712
Phone (847) 324-9728

Interoperability endpoints

  • Direct secure messaging: jlopez368031@direct.myadvocateaurora.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1205440948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 RAND RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161005",
            "telephone_number": "847-296-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Northwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600104607",
            "country_code": "US",
            "telephone_number": "847-381-4105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "936 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600626822",
            "country_code": "US",
            "telephone_number": "847-668-3522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 N Buffalo Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "60089",
            "country_code": "US",
            "telephone_number": "800-225-0394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JENICE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-021901",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "15 N Buffalo Grove Rd",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlopez368031@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "15 N Buffalo Grove Rd",
            "city": "Buffalo Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlopez368031@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "77 Rand Rd",
            "city": "Des Plaines",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600161005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "77 Rand Rd",
            "city": "Des Plaines",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600161005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.