Jennifer Ciccone, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209-004761 Issued in IL

Practice address

1100 Pembridge Dr
Lake Forest, IL 60045-4228

Phone

(847) 604-6700

NPI assigned

Apr 12, 2006

Last updated

May 20, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

University of Massachusetts Medical School, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pain and Wellness Specialists SC

  • Physical Medicine & Rehabilitation Physician
  • Itasca, IL
  • NPI 1104294784
  Medicare reassignment NPD

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1205890878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5253 N OLCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606561709",
            "telephone_number": "773-792-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PEMBRIDGE DR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600454228",
            "telephone_number": "847-604-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCONE",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-004761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kira Nelson Charney, M.D.
• Andrew Worthington Chase-Ziolek, RN, MS, CRNA
• Sarah G Chiren, PA-C
• Andrew Min Jun Choi, MD
• Jonathan Chuko, MD
• Beata Ciemierzynska
• Elizabeth A Ciennik, PA-C
• Christine Maria Ciolko, RPH
• City of Lake Forest
• CJC Services Unlimited Inc

• Adult Health Nurse Practitioner in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.