NPIMap

Individual provider Active NPI

Mary T Rhodes, FNP

  • Family Nurse Practitioner
  • Alsip, IL
National Provider Identifier
1275954117
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209010983 Issued in IL
Practice address
6195 W. 115TH St
Suite a
Alsip, IL 60803-6080
Phone
(312) 262-7002
NPI assigned
Dec 19, 2013
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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 209010983 IL Primary

Addresses

Primary practice location

6195 W. 115TH St
Suite a
Alsip, IL 60803-6080

Mailing address

6195 W. 115TH St
Suite a
Alsip, IL 60803-3703
Phone (312) 262-7002

Other practice location 1

3925 W 103rd St
Chicago, IL 60655-3703
Phone (773) 298-3712

Other identifiers 1

IdentifierTypeStateIssuer
$$$$$$$$$MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140324001450 IL Practitioner - Nurse Practitioner 8325279987 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4179 Dundee Rd
Suite A106
Northbrook, IL 60062-2129
Phone (847) 402-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Little Company of Mary Affiliated Services Inc Current Accepting new patients
Premise Health of Illinois Medical PC CurrentSince Aug 16, 2024 Accepting new patients
Premise Health of Illinois Medical PC CurrentSince Aug 16, 2024 Accepting new patients
Premise Health of Illinois Medical PC Current Accepting new patients
Little Company of Mary Affiliated Services Inc CurrentSince Jan 1, 2014 Accepting new patients
Saint Xavier University CurrentSince Apr 12, 2021 Accepting new patients

Locations

6195 W 115th St
Ste A
Alsip, IL 60803
Phone (312) 262-7002

10961 S Kedzie Ave
Chicago, IL 60655
Phone (773) 239-9100

16906 Collection Ctr Dr
Chicago, IL 60693

2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200

3700 W 103rd St
Chicago, IL 60655
Phone (773) 298-3712

3925 W 103rd St
Chicago, IL 60655
Phone (772) 298-3712

6150 Joliet Rd
Countryside, IL 60525
Phone (708) 485-2273

4979 Indiana Ave
Lisle, IL 60532
Phone (312) 337-4150

5100 Lake Ter NE
Mount Vernon, IL 62864
Phone (618) 244-8793

4179 Dundee Rd
Ste A106
Northbrook, IL 60062
Phone (847) 402-2300

12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207

Organizations & group practices 6

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 6

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": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1275954117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6195 W. 115TH ST",
            "address_2": "SUITE A",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608033703",
            "telephone_number": "312-262-7002",
            "fax_number": "312-262-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6195 W. 115TH ST",
            "address_2": "SUITE A",
            "city": "ALSIP",
            "state": "IL",
            "postal_code": "608036080",
            "telephone_number": "312-262-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 W 103rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606553703",
            "country_code": "US",
            "telephone_number": "773-298-3712",
            "fax_number": "773-298-3906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RHODES",
        "first_name": "MARY",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alsip, IL

Sources for this page

Verify at the official NPI Registry.