Individual provider Active NPI

Caitlin Rebecca Bodner, DNP, FNP-C

  • Family Nurse Practitioner
  • Bellwood, IL
National Provider Identifier
1265292908
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.034129 Issued in IL
Practice address
456 25TH Ave
Bellwood, IL 60104-1961
Phone
(708) 467-7254
Fax
(815) 642-5697
NPI assigned
Mar 20, 2024
Last updated
Jan 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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 209.034129 IL Primary

Addresses

Primary practice location

456 25TH Ave
Bellwood, IL 60104-1961

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (708) 467-7254

Other practice location 1

181 Emmett St W
Battle Creek, MI 49037-2963
Phone (269) 441-1740

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
I20260206001615 IL Practitioner - Nurse Practitioner 8921446808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

456 25TH Ave
Bellwood, IL 60104-1961
Phone (708) 467-7254

4848 W Irving Park Rd
Chicago, IL 60641-2718
Phone (855) 625-7878

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.034129ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Family CurrentSince Feb 2, 2026 Accepting new patients

Locations

456 25th Ave
Bellwood, IL 60104
Phone (708) 467-7254

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

Interoperability endpoints

  • Direct secure messaging: caitlin.bodner.p1@direct.gracehealthmi.nextgenshare.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1265292908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "708-467-7254",
            "fax_number": "815-642-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 25TH AVE",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041961",
            "telephone_number": "708-467-7254",
            "fax_number": "815-642-5697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Emmett St W",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490372963",
            "country_code": "US",
            "telephone_number": "269-441-1740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNER",
        "first_name": "CAITLIN",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.034129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellwood, IL

Sources for this page

Verify at the official NPI Registry.