Individual provider Active NPI

Renee Sheree Gracey, FNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1447033055
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027099 Issued in IL
Practice address
250 E Superior St Ste 4-420
Chicago, IL 60611-2914
Phone
(312) 472-0420
Fax
(312) 926-6363
NPI assigned
Aug 16, 2023
Last updated
Jan 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 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 209027099 IL Primary
Family Nurse Practitioner 363LF0000X 209.027099 IL

Addresses

Primary practice location

250 E Superior St Ste 4-420
Chicago, IL 60611-2914

Mailing address

250 E Superior St Ste 4-420
Chicago, IL 60611-2914
Phone (312) 472-0420

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
I20231110001004 IL Practitioner - Nurse Practitioner 8729435896 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
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1475 E Belvidere Rd
Grayslake, IL 60030-2012

250 E Superior
2304 Nwmff Prent WMN Hosp
Chicago, IL 60611-2914
Phone (312) 472-3660

250 E Superior St
Chicago, IL 60611-2914

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.027099ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 30, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 30, 2023 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

250 E Superior St
Ste 4420
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1447033055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E SUPERIOR ST STE 4-420",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112914",
            "telephone_number": "312-472-0420",
            "fax_number": "312-926-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E SUPERIOR ST STE 4-420",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112914",
            "telephone_number": "312-472-0420",
            "fax_number": "312-926-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACEY",
        "first_name": "RENEE",
        "middle_name": "SHEREE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027099",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.