Individual provider Active NPI

Jennifer Gray Schmidt, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Warrenville, IL
National Provider Identifier
1477206308
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.025795 Issued in IL
Practice address
4580 Weaver Pkwy Ste 102
Warrenville, IL 60555-3864
Phone
(630) 839-9199
Fax
(630) 839-9299
NPI assigned
Jan 31, 2022
Last updated
Mar 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209.025795 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.025795 IL Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 041.438802 IL

Addresses

Primary practice location

4580 Weaver Pkwy Ste 102
Warrenville, IL 60555-3864

Mailing address

4580 Weaver Pkwy Ste 102
Warrenville, IL 60555-3864
Phone (630) 839-9199

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
I20221104000801 IL Practitioner - Nurse Practitioner 0749657773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mugen Psychiatry LLCGroup PAC ID 6002201613, 20 clinicians

Practice addresses (Care Compare)

3023 N Clark St
Suite 593
Chicago, IL 60657-5200
Phone (205) 427-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.438802ILMDPsychiatric/Mental Health Registered Nurse
209.025795ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Center LTD. CurrentSince Sep 1, 2022 Accepting new patients
Mugen Psychiatry LLC CurrentSince Apr 1, 2024 Accepting new patients
Martins Adeoye, LLC PastSince Sep 1, 2022 Accepting new patients
Fulfill Health Past Accepting new patients

Locations

3023 N Clark St
#593
Chicago, IL 60657
Phone (205) 427-9243

3023 N Clark St
Ste 593
Chicago, IL 60657
Phone (205) 427-9243

1323 Butterfield Rd
Ste 116
Downers Grove, IL 60515
Phone (331) 330-9955

14484 John Humphrey Dr
Orland Park, IL 60462
Phone (708) 741-2325

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1477206308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 WEAVER PKWY STE 102",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553864",
            "telephone_number": "630-839-9199",
            "fax_number": "630-839-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 WEAVER PKWY STE 102",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553864",
            "telephone_number": "630-839-9199",
            "fax_number": "630-839-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "JENNIFER",
        "middle_name": "GRAY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.025795",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.025795",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IL",
            "license": "041.438802",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.