Individual provider Active NPI

Lorena Reyes, DNP, CPNP-PC

  • Pediatric Nurse Practitioner
  • Berwyn, IL
National Provider Identifier
1316229503
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209-028758 Issued in IL
Practice address
6545 Cermak Rd
Berwyn, IL 60402-2313
Phone
(708) 788-0077
NPI assigned
Sep 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209-028758 IL Primary

Addresses

Primary practice location

6545 Cermak Rd
Berwyn, IL 60402-2313

Mailing address

6545 Cermak Rd
Berwyn, IL 60402-2313
Phone (708) 788-0077

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
I20250702003924 IL Practitioner - Nurse Practitioner 3476066358 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-028758ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC CurrentSince Aug 1, 2025 Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Locations

1555 N Barrington Rd
Bldg 1
Hoffman Estates, IL 60169
Phone (224) 299-4222

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1316229503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022313",
            "telephone_number": "708-788-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022313",
            "telephone_number": "708-788-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "LORENA",
        "credential": "DNP, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209-028758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.