Organization Active NPI

Rise and Thrive Health Care PLLC

  • Medical Specialty Clinic/Center
  • Joliet, IL
National Provider Identifier
1356956973
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
RISE AND THRIVE HEALTH CARE PLLC
Practice address
1106 N Larkin Ave Lowr Level
Joliet, IL 60435-3455
Phone
(815) 685-4665
Fax
(630) 566-3322
NPI assigned
Sep 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Jessica Kandis Gutierrez, FNP-BC
Title
Owner/Nurse Practitioner
Phone
(815) 685-4665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

1106 N Larkin Ave Lowr Level
Joliet, IL 60435-3455

Mailing address

1106 N Larkin Ave Lowr Level
Joliet, IL 60435-3455
Phone (815) 685-4665

Other identifiers 1

IdentifierTypeStateIssuer
1245876846MedicaidIL

National Provider Directory

National Provider Directory

Locations

210 N Hammes Ave
Ste 112
Joliet, IL 60435
Phone (815) 730-1880

1106 N Larkin Ave
Lowr
Joliet, IL 60435
Phone (815) 685-4665

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1356956973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 N LARKIN AVE LOWR LEVEL",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353455",
            "telephone_number": "815-685-4665",
            "fax_number": "630-566-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 N LARKIN AVE LOWR LEVEL",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353455",
            "telephone_number": "815-685-4665",
            "fax_number": "630-566-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE AND THRIVE HEALTH CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "KANDIS",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "815-685-4665",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245876846",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.