Individual provider Active NPI

Vicky Bustamante, APN

  • Family Nurse Practitioner
  • Park Ridge, IL
National Provider Identifier
1376080440
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015209 Issued in IL
Practice address
1875 Dempster St Ste B06
Park Ridge, IL 60068-1186
Phone
(847) 723-7024
Fax
(847) 723-7369
NPI assigned
Jan 26, 2017
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015209 IL Primary

Addresses

Primary practice location

1875 Dempster St Ste B06
Park Ridge, IL 60068-1186

Mailing address

29373 Network PL
Chicago, IL 60673-1186
Phone (847) 390-5900

Other practice location 1

3000 N Halsted St Ste 323
Chicago, IL 60657-5196
Phone (847) 723-7024

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vbustamante205863@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20180529000147 IL Practitioner - Nurse Practitioner 4082979877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7251 Lake St
River Forest, IL 60305-2238
Phone (224) 225-0240

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jun 18, 2018 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 26, 2023 Accepting new patients
Advocate Health & Hospitals Corp. CurrentSince Jun 18, 2018 Accepting new patients

Locations

27790 W Highway 22
Ste 1
Barrington, IL 60010
Phone (312) 676-9892

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

29373 Network Pl
Chicago, IL 60673

3000 N Halsted St
Ste 323
Chicago, IL 60657
Phone (773) 296-8880

1875 Dempster St
Ste B06
Park Ridge, IL 60068
Phone (847) 723-7024

7251 Lake St
River Forest, IL 60305
Phone (708) 366-9960

Interoperability endpoints

  • Direct secure messaging: vbustamante205863@direct.myadvocateaurora.org

Organizations & group practices 3

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 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": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1376080440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731186",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST STE B06",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-723-7024",
            "fax_number": "847-723-7369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 N Halsted St Ste 323",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575196",
            "country_code": "US",
            "telephone_number": "847-723-7024",
            "fax_number": "847-723-7369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "VICKY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vbustamante205863@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3000 N Halsted St Ste 323",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3000 N Halsted St Ste 323",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.