Individual provider Active NPI

Paige Gudim, NP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1366082588
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209029258 Issued in IL
Practice address
1801 W Taylor St
Chicago, IL 60612-4795
Phone
(312) 413-7500
Fax
(312) 413-3856
NPI assigned
Jan 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209029258 IL Primary

Addresses

Primary practice location

1801 W Taylor St
Chicago, IL 60612-4795

Mailing address

820 S Wood St # Mc808
Chicago, IL 60612-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200219002068 NY Practitioner - Nurse Practitioner 4082041744 Reassigns benefits to 1 organization
I20240725002916 IL Practitioner - Nurse Practitioner 4082041744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 W Taylor St
FL 4
Chicago, IL 60612-4795
Phone (312) 355-6245

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209029258ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Feb 1, 2020 Accepting new patients
Advantagecare Physicians PC Nurse Practitioner CurrentSince Feb 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince May 16, 2024 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince May 16, 2024 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

1801 W Taylor St
Fl 4
Chicago, IL 60612
Phone (312) 413-7500

1309 S Halsted St
Chicago, IL 60607
Phone (312) 413-3000

820 S Wood St
#808
Chicago, IL 60612
Phone (312) 996-7006

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

215 E 95th St
New York, NY 10128
Phone (212) 423-3111

55 Water St
Fl 2
New York, NY 10041

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

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 and National Provider Directory roles.

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": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1366082588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S WOOD ST # MC808",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-413-7500",
            "fax_number": "312-413-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDIM",
        "first_name": "PAIGE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2024-04-16",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209029258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.