Individual provider Active NPI

Taylor Rogers

  • Nurse Practitioner
  • Berwyn, IL
National Provider Identifier
1376389593
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.031043 Issued in IL
Practice address
6840 W Windsor Ave
Berwyn, IL 60402-3486
Phone
(708) 484-0042
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 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 209.031043 IL Primary
Registered Nurse 163W00000X 04145647 IL

Addresses

Primary practice location

6840 W Windsor Ave
Berwyn, IL 60402-3486

Mailing address

1642 N Artesian Ave Apt 2
Chicago, IL 60647-5309
Phone (317) 670-1619

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
I20250815002299 IL Practitioner - Nurse Practitioner 6709385867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Associates LTDGroup PAC ID 7416917059, 9 clinicians

Practice addresses (Care Compare)

6840 W Windsor Ave
Berwyn, IL 60402-3441
Phone (708) 484-0042

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04145647ILMDRegistered Nurse
209.031043ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Associates LTD CurrentSince Jun 6, 2025 Accepting new patients

Locations

6840 W Windsor Ave
Berwyn, IL 60402
Phone (708) 484-0042

Organizations & group practices 1

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 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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1376389593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 N ARTESIAN AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475309",
            "telephone_number": "317-670-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6840 W WINDSOR AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023486",
            "telephone_number": "708-484-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TAYLOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.031043",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "04145647",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.