Individual provider Active NPI

Nancy Maria Mule, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1285917542
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085004139 Issued in IL
Practice address
2320 W Peterson Ave
Chicago, IL 60659-5242
Phone
(773) 508-9800
Fax
(773) 508-1796
NPI assigned
Sep 23, 2011
Last updated
Apr 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085004139 IL Primary

Addresses

Primary practice location

2320 W Peterson Ave
Chicago, IL 60659-5242

Mailing address

2320 W Peterson Ave
Chicago, IL 60659-5242
Phone (773) 508-9800

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
I20111219000573 IL Practitioner - Physician Assistant 4880869924 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America Illinois LLP CurrentSince Aug 1, 2020 Accepting new patients
Cepamerica Illinois LLP CurrentSince Aug 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients
Northwest Community Hospital Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

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": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1285917542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606595242",
            "telephone_number": "773-508-9800",
            "fax_number": "773-508-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606595242",
            "telephone_number": "773-508-9800",
            "fax_number": "773-508-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULE",
        "first_name": "NANCY",
        "middle_name": "MARIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-23",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.