Jessica M Blank, ACNPC-AG
Individual provider Active NPI Acute Care Nurse Practitioner · Elk Grove Village, IL
NPI 1487328134 · NPPES record last updated Jun 10, 2024
Key facts
- NPI
- 1487328134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 209020126 (IL)
- Practice address
- 800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367 - Phone
- (847) 981-3660
- NPI assigned
- Aug 5, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Suburban Pulmonary and Sleep Associates LTD
Practice addresses (Care Compare)
700 E Ogden Ave
Suite 202
Westmont, IL 60559-1296
Phone (630) 789-9785
Hospital & facility affiliations
- Uchicago Medicine Adventhealth Hinsdale
- Uchicago Medicine Adventhealth la Grange
- Uchicago Medicine Adventhealth Glenoaks
- Uchicago Medicine Adventhealth Bolingbrook
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211020000464 | IL | Practitioner - Nurse Practitioner | 1951799238 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suburban Pulmonary & Sleep Associates LTD | Current |
Accepting new patients | |
| Alexian Brothers Medical Care Group NFP | Past | Accepting new patients |
Locations
3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696
700 E Ogden Ave
Ste 202
Westmont, IL 60559
Phone (630) 528-3215
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 209020126 | IL | Yes |
Addresses
Primary practice location
800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367
Mailing address
800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367
Phone (847) 981-3660
Other providers in Elk Grove Village, IL
- Bikash Bhattarai
- Aasia Bhatti
- John Robert Biancalana
- Anne Biedron
- Joseph M. Blair
- Erin Blasier
- Rohna Bober
- John Bogen
- Edwin J Boklewski
- Bonaventure Medical Foundation, LLC
All providers in Elk Grove Village, IL · Acute Care Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.