Individual provider Active NPI

Shelley Joy Bagri, APRN, BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Forest Park, IL
National Provider Identifier
1215950415
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277002708 Issued in IL
Practice address
431 Marengo Ave
Forest Park, IL 60130-1707
Phone
(708) 305-5333
Fax
(708) 221-8525
NPI assigned
Jul 26, 2006
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209-002942 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209-002942 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277002708 IL Primary

Addresses

Primary practice location

431 Marengo Ave
Forest Park, IL 60130-1707

Mailing address

431 Marengo Ave
Forest Park, IL 60130-1707
Phone (708) 305-5333

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
I20080114000469 IL Practitioner - Nurse Practitioner 8426139619 Practice locations: Forest Park, IL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

431 Marengo Ave
Forest Park, IL 60130-1707
Phone (708) 305-5333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209-002942ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neurorehab Consultants PLLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1215950415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301707",
            "telephone_number": "708-305-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301707",
            "telephone_number": "708-305-5333",
            "fax_number": "708-221-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGRI",
        "first_name": "SHELLEY",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209-002942",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209-002942",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277002708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

Verify at the official NPI Registry.