Individual provider Active NPI

Julie Vicencio, NP

  • Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1356739452
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209012352 Issued in IL
Practice address
525 E Congress Pkwy
Crystal Lake, IL 60014
Phone
(630) 962-6280
NPI assigned
Dec 26, 2014
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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 209012352 IL Primary
Family Nurse Practitioner 363LF0000X 209012352 IL

Addresses

Primary practice location

525 E Congress Pkwy
Crystal Lake, IL 60014

Mailing address

3538 Hopewell PL
Elgin, IL 60124-5705
Phone (630) 962-6280

Other practice location 1

486 Randall Rd Unit B
South Elgin, IL 60177-3354
Phone (224) 783-5000

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ Direct
Direct Messaging Address jvicencio286147@direct.myadvocateaurora.org Direct

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
I20170726000045 IL Practitioner - Nurse Practitioner 7113243882 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians
Crystal Lake Immediate Care Physicians LTD.Group PAC ID 2961783139, 17 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

4800 W 129TH St
Alsip, IL 60803-3016
Phone (708) 377-2169

525 E Congress Pkwy
Suite 100
Crystal Lake, IL 60014-6271
Phone (626) 327-6795

600 S Randall Rd
Algonquin, IL 60102-5935
Phone (224) 783-4300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209012352ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Aug 21, 2017 Accepting new patients
Lake County Immediate Care, LLC CurrentSince Feb 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 18, 2020 Accepting new patients
Lake County Immediate Care, LLC CurrentSince Feb 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Mar 18, 2020 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 1, 2023 Accepting new patients
Crystal Lake Immediate Care Physicians LTD. CurrentSince Oct 15, 2020 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Oct 14, 2024 Accepting new patients
Tri-County Emergency Physicians, LTD CurrentSince Oct 15, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 1, 2020 Accepting new patients
Get It Together PLLC Family CurrentSince Oct 1, 2023 Accepting new patients
Cepamerica Illinois LLP Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Dec 1, 2023 Accepting new patients
Cepamerica Illinois LLP CurrentSince Jan 1, 2020 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

420 E Il Route 173
Ste 101
Antioch, IL 60002
Phone (847) 652-9700

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

9501 S Western Ave
Chicago, IL 60643
Phone (773) 344-9465

9532 Eagle Way
Chicago, IL 60678

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

525 E Congress Pkwy
Crystal Lake, IL 60014
Phone (815) 479-8020

525 E Congress Pkwy
Ste 100
Crystal Lake, IL 60014
Phone (626) 327-6795

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

1420 Busse Rd
Elk Grove Vlg, IL 60007
Phone (847) 653-0142

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

1849 Green Bay Rd
Ste 171
Highland Park, IL 60035
Phone (847) 901-8400

1000 E Riverside Blvd
Loves Park, IL 61111
Phone (815) 633-4300

4800 W 129th St
Merrionette Park, IL 60803
Phone (708) 377-2169

9977 Woods Dr
Skokie, IL 60077
Phone (847) 663-8540

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

486 Randall Rd
Unit B
South Elgin, IL 60177
Phone (224) 783-5000

724 N Green Bay Rd
Waukegan, IL 60085
Phone (847) 901-8400

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

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": "1419552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1356739452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 HOPEWELL PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601245705",
            "telephone_number": "630-962-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "60014",
            "telephone_number": "630-962-6280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "486 Randall Rd Unit B",
            "address_purpose": "LOCATION",
            "city": "South Elgin",
            "state": "IL",
            "postal_code": "601773354",
            "country_code": "US",
            "telephone_number": "224-783-5000",
            "fax_number": "224-782-5018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICENCIO",
        "first_name": "JULIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-26",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209012352",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012352",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "486 Randall Rd Unit B",
            "city": "South Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601773354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvicencio286147@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "486 Randall Rd Unit B",
            "city": "South Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601773354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.