Individual provider Active NPI

She Zhao, FNP-BC,

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1508272964
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.015416 Issued in IL
Practice address
3245 N Halsted St
Chicago, IL 60657-3419
Phone
(773) 388-1600
Fax
(773) 388-8936
NPI assigned
Jul 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 671943 NY
Family Nurse Practitioner 363LF0000X 339358 NY
Family Nurse Practitioner 363LF0000X 209.015416 IL Primary

Addresses

Primary practice location

3245 N Halsted St
Chicago, IL 60657-3419

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

Other practice location 1

3414 Church Ave
Brooklyn, NY 11203-2714
Phone (718) 630-2197

Other identifiers 1

IdentifierTypeStateIssuer
209015416MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150331000713 NY Practitioner - Nurse Practitioner 9133446248 Reassigns benefits to 1 organization
I20170719000857 IL Practitioner - Nurse Practitioner 9133446248 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
Howard Brown Health CenterGroup PAC ID 1052203155, 52 clinicians

Practice addresses (Care Compare)

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
671943NYMDRegistered Nurse
209.015416ILMDFamily Nurse Practitioner
339358NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center CurrentSince Jun 3, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 18, 2017 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 18, 2017 Accepting new patients
NYU Langone Hospitals Registered Nurse Current Accepting new patients
Howard Brown Health Center CurrentSince Jun 3, 2017 Accepting new patients
Howard Brown Health Center Current Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

3245 N Halsted St
Chicago, IL 60657
Phone (773) 296-8400

4025 N Sheridan Rd
Chicago, IL 60613
Phone (773) 388-1800

3414 Church Ave
Brooklyn, NY 11203
Phone (718) 630-2197

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

Interoperability endpoints

  • Direct secure messaging: szhao581241@direct.ochin.org

Organizations & group practices 7

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": "1404691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1508272964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 N HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573419",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3414 Church Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032714",
            "country_code": "US",
            "telephone_number": "718-630-2197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHAO",
        "first_name": "SHE",
        "credential": "FNP-BC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-07",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "671943",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "339358",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209015416",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.