Individual provider Active NPI

Shauna Leigh Acosta, APRN, CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1285001867
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209013135 Issued in IL
Practice address
259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone
(312) 695-7269
Fax
(312) 695-4924
NPI assigned
Aug 30, 2015
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209013135 IL Primary
Women's Health Nurse Practitioner 363LW0102X 209.013135 IL

Addresses

Primary practice location

259 E Erie St Ste 2400
Chicago, IL 60611-3907

Mailing address

259 E Erie St Ste 2400
Chicago, IL 60611-3907
Phone (312) 695-7269

Other names 1

  • Shauna Leigh Gardino Former name

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
I20180109002299 IL Practitioner - Nurse Practitioner 6507125069 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209013135ILMDNurse Practitioner
209.013135ILMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jun 19, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 18, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 18, 2023 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Access Community Health Network CurrentSince Dec 11, 2017 Accepting new patients
Access Community Health Network CurrentSince Dec 11, 2017 Accepting new patients
Access Community Health Network Current Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

259 E Erie St
Ste 2400
Chicago, IL 60611
Phone (312) 694-9676

3303 W 26th St
Chicago, IL 60623
Phone (773) 277-6589

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 8

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": "1440892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1285001867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 2400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113907",
            "telephone_number": "312-695-7269",
            "fax_number": "312-695-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "SHAUNA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-30",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013135",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209.013135",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUNA",
            "last_name": "GARDINO",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.