Individual provider Active NPI

Ellen R Walukas, DNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1508581851
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.029563 Issued in IL
Practice address
1541 W Devon Ave
Chicago, IL 60660-1313
Phone
(773) 250-5222
Fax
(773) 866-8018
NPI assigned
Oct 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704344232 MI
Family Nurse Practitioner 363LF0000X 209.029563 IL Primary

Addresses

Primary practice location

1541 W Devon Ave
Chicago, IL 60660-1313

Mailing address

PO Box 746715
Atlanta, GA 30374-6715
Phone (773) 352-1515

Other practice location 1

2305 Genoa Business Park Dr Ste 200
Brighton, MI 48114-7005
Phone (810) 494-6840

Other names 1

  • Ellen Rabaut Former name

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
I20240610003480 IL Practitioner - Nurse Practitioner 4284004946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health Physicians Group PCGroup PAC ID 7517109879, 227 clinicians

Practice addresses (Care Compare)

1541 W Devon Ave
Chicago, IL 60660-1313
Phone (773) 250-5222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.029563ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group, PC Family CurrentSince Jul 22, 2024 Accepting new patients

Locations

1541 W Devon Ave
Chicago, IL 60660
Phone (312) 360-1983

4848 W Irving Park Rd
Chicago, IL 60641
Phone (773) 724-6200

Interoperability endpoints

  • Direct secure messaging: erabaut186664@direct.trinity-health.org

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.

Hospital & facility affiliations 2

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": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1508581851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746715",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746715",
            "telephone_number": "773-352-1515",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601313",
            "telephone_number": "773-250-5222",
            "fax_number": "773-866-8018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2305 Genoa Business Park Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481147005",
            "country_code": "US",
            "telephone_number": "810-494-6840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALUKAS",
        "first_name": "ELLEN",
        "middle_name": "R",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704344232",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "RABAUT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.