Active NPI
Jacqueline Sarah Elegant, NP
- Critical Care Pediatric Nurse Practitioner
- Chicago, IL
National Provider Identifier
1326480021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- 291.010126
- Practice address
- 225 E Chicago Ave
Mailstop 246
Chicago, IL 60611-2991 - Phone
- (847) 274-9050
- NPI assigned
- Jul 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | 291.010126 | IL | Primary |
Addresses
Primary practice location
225 E Chicago Ave
Mailstop 246
Chicago, IL 60611-2991
Mailing address
225 E Chicago Ave
Mailstop 246
Chicago, IL 60611-2991
Phone (847) 274-9050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
225 E Chicago Ave
Chicago, IL 60611-2991
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 291.010126 | IL | MD | Critical Care Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374537600000",
"number": "1326480021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"address_2": "MAILSTOP 246",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "847-274-9050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 E CHICAGO AVE",
"address_2": "MAILSTOP 246",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112991",
"telephone_number": "847-274-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELEGANT",
"first_name": "JACQUELINE",
"middle_name": "SARAH",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-23",
"last_updated": "2013-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "IL",
"license": "291.010126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.