Individual provider Active NPI

Aida Ruth Gabo Bearnod, NP

  • Family Nurse Practitioner
  • Gurnee, IL
National Provider Identifier
1255925236
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.024085 Issued in IL
Practice address
33831 N Summerfields Dr
Gurnee, IL 60031-4273
Phone
(847) 337-5323
Fax
(847) 604-6708
NPI assigned
Feb 21, 2021
Last updated
Dec 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.024085 IL Primary
General Practice Registered Nurse 163WG0000X 041.287233 IL

Addresses

Primary practice location

33831 N Summerfields Dr
Gurnee, IL 60031-4273

Mailing address

33831 N Summerfields Dr
Gurnee, IL 60031-4273
Phone (847) 337-5323

Other names 1

  • Mrs. Aida Gabo Bearnod Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abearnod521@usuniversity.edu Other

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
I20210708001419 IL Practitioner - Nurse Practitioner 3870657083 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
Integra Healthcare SCGroup PAC ID 0042539173, 15 clinicians

Practice addresses (Care Compare)

2504 Washington St
Waukegan, IL 60085-4983
Phone (847) 623-7590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041.287233ILMDGeneral Practice Registered Nurse
209.024085ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Dec 27, 2024 Accepting new patients
Integra Healthcare SC CurrentSince Aug 1, 2021 Accepting new patients
Hansa Medical Groupe PLLC CurrentSince Apr 1, 2021 Accepting new patients

Locations

4655 W Chase Ave
Lincolnwood, IL 60712
Phone 8472623800202

2504 Washington St
Waukegan, IL 60085
Phone (847) 336-2288

2534 Elim Ave
Zion, IL 60099
Phone (847) 328-6503

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 701-2379

Organizations & group practices 3

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": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1255925236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33831 N SUMMERFIELDS DR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314273",
            "telephone_number": "847-337-5323",
            "fax_number": "847-604-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33831 N SUMMERFIELDS DR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314273",
            "telephone_number": "847-337-5323",
            "fax_number": "847-604-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEARNOD",
        "first_name": "AIDA RUTH",
        "middle_name": "GABO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024085",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041.287233",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abearnod521@usuniversity.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "8473375323",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cell phone",
            "address_1": "5250 Old Orchard Rd",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600774460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AIDA",
            "last_name": "BEARNOD",
            "middle_name": "GABO",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.