Individual provider Active NPI

Grace Jeong

  • Family Nurse Practitioner
  • Schaumburg, IL
National Provider Identifier
1366273765
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.029983 Issued in IL
Practice address
804 E Woodfield Rd Ste 300
Schaumburg, IL 60173-4776
Phone
(847) 605-9500
NPI assigned
Aug 8, 2024
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 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 209.029983 IL
Family Nurse Practitioner 363LF0000X 209.029983 IL Primary

Addresses

Primary practice location

804 E Woodfield Rd Ste 300
Schaumburg, IL 60173-4776

Mailing address

975 Livingston LN
Inverness, IL 60010-6436

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
I20250124002624 IL Practitioner - Nurse Practitioner 8123557832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Chicago Cardiology Institute SCGroup PAC ID 6103983176, 23 clinicians

Practice addresses (Care Compare)

804 E Woodfield Rd
Suite 300
Schaumburg, IL 60173-4776
Phone (847) 605-9500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.029983ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Cardiology Institute S.C. CurrentSince Nov 23, 2024 Accepting new patients
Chicago Vascular Clinic LTD PastSince Oct 1, 2013 Accepting new patients
Dev Medical Associates SC PastSince Jun 1, 2006 Accepting new patients
Mohammad Waseem Kagzi MD LTD PastSince Aug 11, 2024 Accepting new patients

Locations

7447 W Talcott Ave
Ste 525
Chicago, IL 60631
Phone (773) 763-1146

802 E Woodfield Rd
Ste 200
Schaumburg, IL 60173
Phone (847) 240-9500

804 E Woodfield Rd
Schaumburg, IL 60173
Phone (847) 605-0030

804 E Woodfield Rd
Ste 300
Schaumburg, IL 60173
Phone (847) 605-0030

812 E Woodfield Rd
Schaumburg, IL 60173
Phone (847) 605-0030

Interoperability endpoints

  • Direct secure messaging: grace.jeong.p1@direct.chicagocardiology.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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 2

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": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1366273765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 LIVINGSTON LN",
            "city": "INVERNESS",
            "state": "IL",
            "postal_code": "600106436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E WOODFIELD RD STE 300",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734776",
            "telephone_number": "847-605-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEONG",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.029983",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.