Penelope Grace Ruppert

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209026393 Issued in IL

Practice address

572B Lincoln Ave
Winnetka, IL 60093-2308

Phone

(847) 501-4040

Fax

(847) 501-4075

NPI assigned

Jan 30, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pruppert276866@uchospital.direct-ci.com

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.

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1366158529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572B LINCOLN AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932308",
            "telephone_number": "847-501-4040",
            "fax_number": "847-501-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572B LINCOLN AVE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600932308",
            "telephone_number": "847-501-4040",
            "fax_number": "847-501-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPPERT",
        "first_name": "PENELOPE",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209026393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Roderick, P.T.
• Kristin Romani, ATC
• Jason Andrew Romano, D.C.
• Nancy Rosen, LPC
• Jacob Rothstein, CCC-SLP
• Zachary Ryan, D.C.
• Samaritan Counseling Center
• Sante Integrated Health and Wellness
• Barbara Scott
• Vicki Lynn Seglin, PH.D.

• Pediatric Nurse Practitioner in Winnetka, IL
• Providers in Winnetka, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.