Individual provider Active NPI

Erika Marie Regacho, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1508562687
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209026734 Issued in IL
Practice address
3023 N Clark St Ste 593
Chicago, IL 60657-5200
Phone
(630) 550-9454
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026734 IL Primary

Addresses

Primary practice location

3023 N Clark St Ste 593
Chicago, IL 60657-5200

Mailing address

1111 W 14TH PL Unit 318
Chicago, IL 60608-2843
Phone (630) 550-9454

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
I20230706003895 IL Practitioner - Nurse Practitioner 3375902406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mugen Psychiatry LLCGroup PAC ID 6002201613, 20 clinicians

Practice addresses (Care Compare)

3023 N Clark St
Suite 593
Chicago, IL 60657-5200
Phone (205) 427-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209026734ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mugen Psychiatry LLC CurrentSince Apr 18, 2023 Accepting new patients

Locations

3023 N Clark St
Ste 593
Chicago, IL 60657
Phone (205) 427-9243

3023 N Clark St
#593
Chicago, IL 60657
Phone (205) 427-9243

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1508562687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W 14TH PL UNIT 318",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082843",
            "telephone_number": "630-550-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 N CLARK ST STE 593",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575200",
            "telephone_number": "630-550-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGACHO",
        "first_name": "ERIKA MARIE",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209026734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.