Individual provider Active NPI

Mary Farley, APRN

  • Nurse Practitioner
  • Mount Prospect, IL
National Provider Identifier
1295334811
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022213 Issued in IL
Practice address
199 W Rand Rd
Mount Prospect, IL 60056-1151
Phone
(847) 618-5400
NPI assigned
Oct 24, 2020
Last updated
Dec 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022213 IL Primary

Addresses

Primary practice location

199 W Rand Rd
Mount Prospect, IL 60056-1151

Mailing address

2650 Ridge Ave Ste 1223
Evanston, IL 60201-1700
Phone (847) 570-2040

Other practice location 1

Mercyhealth Javon Bea Hospital Riverside
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7255

Other identifiers 1

IdentifierTypeStateIssuer
209022213OtherILSTATE LICENSE

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
I20210622002632 IL Practitioner - Nurse Practitioner 5698176154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1450 Busch Pkwy
Buffalo Grove, IL 60089-4541
Phone (847) 725-8640

199 W Rand Rd
Mount Prospect, IL 60056-1151
Phone (847) 618-5400

21481 N Rand Rd
Kildeer, IL 60047-3061
Phone (847) 618-9696

2650 Ridge Ave
Evanston, IL 60201-1700

455 S Roselle Rd
Schaumburg, IL 60193-2971
Phone (847) 985-0600

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209022213ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince May 24, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2024 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

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

199 W Rand Rd
Mt Prospect, IL 60056
Phone (847) 618-5400

2300 N Rockton Ave
Rockford, IL 61103

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

Interoperability endpoints

  • Direct secure messaging: mfarley82446@direct.mhemail.org

Organizations & group practices 3

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 2

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": "1603497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1295334811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 W RAND RD",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600561151",
            "telephone_number": "847-618-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mercyhealth Javon Bea Hospital Riverside",
            "address_2": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-24",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209022213",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.