Individual provider Active NPI

Venus Liezl Basnillo, APN

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1265971204
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209015653 Issued in IL
Practice address
5425 W Belmont Ave
Chicago, IL 60641-4127
Phone
(312) 702-1313
Fax
(844) 269-6602
NPI assigned
Feb 22, 2017
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209015653 IL Primary

Addresses

Primary practice location

5425 W Belmont Ave
Chicago, IL 60641-4127

Mailing address

5425 W Belmont Ave
Chicago, IL 60641-4127
Phone (312) 702-1313

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
I20171219000853 IL Practitioner - Nurse Practitioner 9931467016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Pain and Back Institute IncGroup PAC ID 6800196031, 2 clinicians

Practice addresses (Care Compare)

5425 W Belmont Ave
Chicago, IL 60641-4127
Phone (312) 702-1313

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015653ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain & Back Institute, Inc. CurrentSince Mar 1, 2019 Accepting new patients

Locations

5425 W Belmont Ave
Chicago, IL 60641
Phone (312) 702-1313

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": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1265971204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414127",
            "telephone_number": "312-702-1313",
            "fax_number": "844-269-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414127",
            "telephone_number": "312-702-1313",
            "fax_number": "844-269-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASNILLO",
        "first_name": "VENUS LIEZL",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209015653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.