Individual provider Active NPI

Maria Luz Chattic, FNP-BC

  • Family Nurse Practitioner
  • Dixon, IL
National Provider Identifier
1407583966
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209025358 Issued in IL
Practice address
1170 Bay Dr
Dixon, IL 61021-7701
Phone
(815) 441-3214
NPI assigned
Aug 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 041331252 IL
Family Nurse Practitioner 363LF0000X 209025358 IL Primary

Addresses

Primary practice location

1170 Bay Dr
Dixon, IL 61021-7701

Mailing address

1170 Bay Dr
Dixon, IL 61021-7701
Phone (815) 441-3214

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
I20241118000307 IL Practitioner - Nurse Practitioner 9234663964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGH Medical CenterGroup PAC ID 6103723267, 199 clinicians

Practice addresses (Care Compare)

101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790

1319 N Galena Ave
Dixon, IL 61021-1009
Phone (815) 624-4790

1321 N Galena Ave
Dixon, IL 61021-1009
Phone (815) 284-1600

15 W 3Rd St
Sterling, IL 61081-3510
Phone (815) 625-0226

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041331252ILMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CGH Medical Center Current Accepting new patients
CGH Medical Center CurrentSince Oct 1, 2024 Accepting new patients
CGH Medical Center CurrentSince Oct 1, 2024 Accepting new patients

Locations

101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285

Interoperability endpoints

  • Direct secure messaging: mchattic21657@cghmc.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1407583966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 BAY DR",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610217701",
            "telephone_number": "815-441-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 BAY DR",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610217701",
            "telephone_number": "815-441-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATTIC",
        "first_name": "MARIA",
        "middle_name": "LUZ",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041331252",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

Verify at the official NPI Registry.