Individual provider Active NPI

Jasmine Macabulos, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1295587376
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.029389 Issued in IL
Practice address
1801 W Taylor St Ste 1C
Chicago, IL 60612-4795
Phone
(312) 413-3631
NPI assigned
Apr 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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 209.029389 IL Primary

Addresses

Primary practice location

1801 W Taylor St Ste 1C
Chicago, IL 60612-4795

Mailing address

5 Helens Way CT
Naperville, IL 60565-1107
Phone (708) 306-5634

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
I20240731002901 IL Practitioner - Nurse Practitioner 2062959646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

1801 W Taylor St
Chicago, IL 60612-4795

5525 S Pulaski Rd
Chicago, IL 60629-4400
Phone (312) 996-2779

845 W Wilson Ave
Uic Medicine
Chicago, IL 60640-8090
Phone (312) 744-1295

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.029389ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jul 7, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 7, 2024 Accepting new patients

Locations

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

1801 W Taylor St
Ste 1C
Chicago, IL 60612
Phone (312) 413-3631

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

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 and National Provider Directory roles.

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": "1712102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1295587376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HELENS WAY CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605651107",
            "telephone_number": "708-306-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST STE 1C",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-413-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACABULOS",
        "first_name": "JASMINE",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.