Individual provider Active NPI

Lauren Broucek, MSN, APN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1508227364
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209013997 Issued in IL
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

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160324001749 IL Practitioner - Nurse Practitioner 0143527705 Reassigns benefits to 1 organization

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
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

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 Hospital, Chicago, IL, CCN 140281
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211

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
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209013997ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Mar 8, 2016 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 8, 2016 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.

Hospital & facility affiliations 6

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": "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

Verify at the official NPI Registry.