Active NPI
Lauren Broucek, MSN, APN, FNP-BC
- Family Nurse Practitioner
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209013997
- Practice address
- 675 N Saint Clair St
Suite 19-100
Chicago, IL 60611-5975 - Phone
- (312) 695-7969
- Fax
- (312) 695-5724
- NPI assigned
- Mar 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209013997 | IL | Primary |
Addresses
Primary practice location
675 N Saint Clair St
Suite 19-100
Chicago, IL 60611-5975
Mailing address
675 N Saint Clair St
Suite 19-100
Chicago, IL 60611-5975
Phone (312) 695-7969
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4445 W Irving Park Rd
Chicago, IL 60641-2808
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
Hospital & facility affiliations
- Northwestern Memorial Hospital
- Northwestern Lake Forest Hospital
- Palos Community Hospital
- Northwestern Medicine McHenry
- Northwestern Medicine Delnor Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209013997 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
675 N Saint Clair St
Ste 19100
Chicago, IL 60611
Phone (312) 664-3278
680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Geneva, IL
- NPI 1407859655
-
- General Acute Care Hospital
- McHenry, IL
- NPI 1982611281
-
- General Acute Care Hospital
- Lake Forest, IL
- NPI 1124025176
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
-
- Psychiatric Hospital Unit
- Palos Heights, IL
- NPI 1184699118
-
- General Acute Care Hospital
- Palos Heights, IL
- NPI 1851386692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457395200000",
"number": "1508227364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 N SAINT CLAIR ST",
"address_2": "SUITE 19-100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115975",
"telephone_number": "312-695-7969",
"fax_number": "312-695-5724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 N SAINT CLAIR ST",
"address_2": "SUITE 19-100",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115975",
"telephone_number": "312-695-7969",
"fax_number": "312-695-5724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUCEK",
"first_name": "LAUREN",
"credential": "MSN, APN, FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-08",
"last_updated": "2016-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209013997",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.