Beverly Black

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209031260 Issued in IL

Practice address

5841 S Maryland Ave
Chicago, IL 60637-1443

Phone

(888) 824-0200

NPI assigned

Jul 18, 2023

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment Care Compare group NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• The University of Chicago Medical Center

  dba UCMC Pharmacy Services

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD
• Respiratory Consultants PA

  • Pulmonary Disease Physician
  • Robbinsdale, MN
  • NPI 1356439277
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1518647346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W ROSCOE ST APT 323",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571012",
            "telephone_number": "847-899-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "888-824-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 W Harrison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123801",
            "country_code": "US",
            "telephone_number": "312-942-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BEVERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-18",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209031260",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041439265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bblack466474@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Black Tie Therapy
• Teresa Black-Jordan
• Adam Black, MD
• Amy Louise Black, DT
• Ashley Black, APN
• Brenda N Black, LCSW
• Elizabeth Black
• Grace Elizabeth Black
• Jacques D Black, LSW
• Jessica L Black, LCPC

• Certified Registered Nurse Anesthetist in Chicago, IL
• Providers in Chicago, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.