Individual provider Active NPI

Siobhan Lynch, FNP-C

  • Family Nurse Practitioner
  • Wauconda, IL
National Provider Identifier
1265109045
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023827 Issued in IL
Practice address
755 Appaloosa TRL
Wauconda, IL 60084-2392
Phone
(847) 208-6176
NPI assigned
Aug 27, 2021
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 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 209.023827 IL Primary
Registered Nurse 163W00000X 041.394944 IL

Addresses

Primary practice location

755 Appaloosa TRL
Wauconda, IL 60084-2392

Mailing address

755 Appaloosa TRL
Wauconda, IL 60084-2392
Phone (847) 208-6176

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
I20211111000865 IL Practitioner - Nurse Practitioner 6305235425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Telemedico Physicians Pulmonary SCGroup PAC ID 6608294400, 17 clinicians

Practice addresses (Care Compare)

3901 Glenview Rd
Glenview, IL 60025-2467
Phone (847) 386-7744

Merit-based Incentive Payment System (MIPS)

Final score
93.72 of 100Reported as group
Quality
75.99
Improvement activities
40
Cost
77.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041.394944ILMDRegistered Nurse
209.023827ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Telemedico Physicians Pulmonary SC CurrentSince Dec 6, 2021 Accepting new patients

Locations

601 W Lincoln Ave
Caseyville, IL 62232
Phone (618) 344-9355

3330 Skokie Valley Rd
Ste 200
Highland Park, IL 60035
Phone 8473867744202

1666 Checker Rd
Long Grove, IL 60047
Phone (847) 419-1111

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, 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": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1265109045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 APPALOOSA TRL",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842392",
            "telephone_number": "847-208-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 APPALOOSA TRL",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842392",
            "telephone_number": "847-208-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "SIOBHAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023827",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.394944",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauconda, IL

Sources for this page

Verify at the official NPI Registry.