Jessica A Fanucchi, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209013322 Issued in IL

Practice address

4709 Golf Rd Ste 900
Skokie, IL 60076

Phone

(847) 676-5394

Fax

(847) 679-7183

NPI assigned

Nov 20, 2015

Last updated

Apr 27, 2021By 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

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfanucchi255191@direct.myadvocateaurora.org

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.

• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Kids First Pediatric Partners SC

  • Pediatrics Physician
  • Skokie, IL
  • NPI 1326263476
  NPD (past)

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1255705794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761244",
            "telephone_number": "847-676-5394",
            "fax_number": "847-679-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 GOLF RD STE 900",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-676-5394",
            "fax_number": "847-679-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANUCCHI",
        "first_name": "JESSICA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2021-04-27",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209013322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED",
            "identifier": "209.013322",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tfrank@kfpp.occ-direct.com",
            "affiliation": "N",
            "address_1": "4709 Golf Rd Ste 900",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Family Doctors/Family Healthcare (NorthShore Laser)
• Family Home Care Inc
• Faminamed Healthcare Providers S.C
• Fancher Psychology and Assessment, LLC
• Robert Joshua Fantus, M.D.
• Andrea Farfan
• Catherine Cress Farley, RPH
• Helen Ann Farrell, L.C.S.W.
• Elizabeth Faustmann, NP
• Karen Fayden, LCSW

• Pediatric Nurse Practitioner in Skokie, IL
• Providers in Skokie, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.

Verify at the official NPI Registry.