Individual provider Active NPI

Jessica M Mendez, APRN,FNP-C

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1487125704
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8902-33 Issued in WI
Practice address
200 S Wacker Dr FL 31
Chicago, IL 60606-5877
Phone
(866) 849-0692
NPI assigned
Dec 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 290397 AZ
Family Nurse Practitioner 363LF0000X 0034241 OH
Family Nurse Practitioner 363LF0000X 277001872 IL
Family Nurse Practitioner 363LF0000X 8902-33 WI Primary

Addresses

Primary practice location

200 S Wacker Dr FL 31
Chicago, IL 60606-5877

Mailing address

PO Box 211699
Eagan, MN 55121-3699
Phone (866) 849-0692

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
I20200205002626 IL Practitioner - Nurse Practitioner 5698015337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Wellness PLLCGroup PAC ID 4688016710, 7 clinicians

Practice addresses (Care Compare)

50 S Milwaukee Ave
Suite 103
Lake Villa, IL 60046-9407
Phone (224) 215-6242

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277001872ILMDFamily Nurse Practitioner
0034241OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Wellness, PLLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

50 S Milwaukee Ave
Ste 103
Lake Villa, IL 60046
Phone (224) 215-6242

50 S Milwaukee Ave
Lake Villa, IL 60046
Phone (224) 627-9155

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.

NPI Registry JSON

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

{
    "created_epoch": "1544745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1487125704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211699",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551213699",
            "telephone_number": "866-849-0692",
            "fax_number": "888-973-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WACKER DR FL 31",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065877",
            "telephone_number": "866-849-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "JESSICA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN,FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "290397",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0034241",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001872",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8902-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.