Amber M. Altidor, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209024124 Issued in IL

Practice address

2501 Chatham Rd
Ste 4134
Springfield, IL 62704-6270

Phone

(773) 716-3478

Fax

(618) 822-4030

NPI assigned

Oct 2, 2021

Sex

Female

Sole proprietor

No

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  IL

  Medicare reassignment Care Compare group NPD
• Optimal Mental Health PLLC

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1073230751
  NPD Authorized official
• Rush University Medical Center

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1689165540
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728

  Hospital

  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1633132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1407528987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM ROAD",
            "address_2": "SUITE 4134",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045746",
            "telephone_number": "773-716-3478",
            "fax_number": "618-822-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD",
            "address_2": "STE 4134",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046270",
            "telephone_number": "773-716-3478",
            "fax_number": "618-822-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTIDOR",
        "first_name": "AMBER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-02",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209024124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tasnem Alsebai, MBBS
• Muath Alsharif, MD
• Alterna-Care Inc.
• Alternative Care Services
• Autumn Altheide, CRNA
• Lizbeth Alvarenga, RBT
• Jessica L. Alwerdt, PHYSICIAN ASSISTANT
• Ronahy Fawaz Alzagha
• James L Ambrose, MD
• Amedisys Illinois LLC

• Psychiatric/Mental Health Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.