Individual provider Active NPI

Kayleigh Persino, ANP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1215423660
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209016397 Issued in IL
Practice address
30 N Michigan Ave Ste 629
Chicago, IL 60602-3822
Phone
(815) 347-8016
NPI assigned
Jul 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209016397 IL Primary

Addresses

Primary practice location

30 N Michigan Ave Ste 629
Chicago, IL 60602-3822

Mailing address

30 N Michigan Ave Ste 629
Chicago, IL 60602-3822
Phone (312) 641-6228

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
I20240306002246 IL Practitioner - Nurse Practitioner 5799121356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1420 Busse Rd
Elk Grove Village, IL 60007-5324
Phone (847) 653-0142

1840 N Richmond Rd
McHenry, IL 60051-5416
Phone (779) 704-3075

335 E Army Trail Rd
Glendale Heights, IL 60139-1755
Phone (630) 735-1400

405 W Golf Rd
Schaumburg, IL 60195-3501
Phone (224) 215-0011

416 S Milwaukee Ave
Libertyville, IL 60048-2821
Phone (847) 979-1112

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

4900 N Cumberland Ave
Norridge, IL 60706-2901
Phone (708) 456-1600

8630 W Golf Rd
Niles, IL 60714-5600
Phone (847) 299-0009

901 E Rand Rd
Mount Prospect, IL 60056-2580
Phone (708) 675-7966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209016397ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Mar 11, 2024 Accepting new patients

Locations

800 W Fulton Market
Fl 12
Chicago, IL 60607

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

9501 S Western Ave
Chicago, IL 60643
Phone (773) 344-9465

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

621 E Lincoln Hwy
New Lenox, IL 60451
Phone (815) 907-5955

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.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1215423660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 629",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023822",
            "telephone_number": "312-641-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 629",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023822",
            "telephone_number": "815-347-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSINO",
        "first_name": "KAYLEIGH",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.