Individual provider Active NPI

Kristine Lynette Montero Nichols, APN-CNP

  • Nurse Practitioner
  • Elmhurst, IL
National Provider Identifier
1356614796
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009118 Issued in IL
Practice address
755 N York St
Elmhurst, IL 60126-1607
Phone
(630) 527-3645
Fax
(331) 221-3883
NPI assigned
Feb 15, 2012
Last updated
May 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209009118 IL Primary
Family Nurse Practitioner 363LF0000X 209009118 IL

Addresses

Primary practice location

755 N York St
Elmhurst, IL 60126-1607

Mailing address

755 N York St
Elmhurst, IL 60126-1607
Phone (630) 527-3645

Other names 1

  • Kristine Lynette Montero Nichols Other name

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
I20120330000054 IL Practitioner - Nurse Practitioner 7810157781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2205 Butterfield Rd
Downers Grove, IL 60515-1157
Phone (630) 527-3645

2650 Ridge Ave
Evanston, IL 60201-1700

755 N York St
Elmhurst, IL 60126-1607
Phone (331) 221-2900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209009118ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Jun 5, 2019 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Edward Health Ventures CurrentSince Jun 5, 2019 Accepting new patients
Edward Health Ventures Past Accepting new patients

Locations

1127 S York Rd
Bensenville, IL 60106
Phone (630) 238-0181

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

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

16519 S Route 59
Plainfield, IL 60586
Phone (630) 646-5020

24600 W 127th St
Ste B100
Plainfield, IL 60585
Phone (815) 731-9000

Interoperability endpoints

  • Direct secure messaging: knichols109372@direct.edward.org

Organizations & group practices 5

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 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": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1356614796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261607",
            "telephone_number": "630-527-3645",
            "fax_number": "331-221-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261607",
            "telephone_number": "630-527-3645",
            "fax_number": "331-221-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTERO NICHOLS",
        "first_name": "KRISTINE",
        "middle_name": "LYNETTE",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009118",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009118",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MONTERO NICHOLS",
            "middle_name": "LYNETTE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.