Individual provider Active NPI

Roberto George, APRN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1528602646
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023750 Issued in IL
Practice address
2001 S California Ave
Chicago, IL 60608-2486
Phone
(773) 640-5784
NPI assigned
Oct 31, 2019
Last updated
Aug 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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 209.023750 IL Primary
Registered Nurse 163W00000X 041.444842 IL

Addresses

Primary practice location

2001 S California Ave
Chicago, IL 60608-2486

Mailing address

2001 S California Ave
Chicago, IL 60608-2486
Phone (773) 640-5784

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
I20211227000507 IL Practitioner - Nurse Practitioner 7214328459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.444842ILMDRegistered Nurse
209.023750ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Centers Current Accepting new patients
Esperanza Health Centers CurrentSince Sep 27, 2021 Accepting new patients
Esperanza Health Centers CurrentSince Sep 27, 2021 Accepting new patients

Locations

1940 S Western Ave
#205
Chicago, IL 60608
Phone (631) 877-0913

2001 S California Ave
Chicago, IL 60608
Phone (773) 484-1201

2001 S California Ave
Ste 100
Chicago, IL 60608
Phone (773) 640-5785

4700 S California Ave
Chicago, IL 60632
Phone (708) 713-0078

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4
  • Direct secure messaging: roberto.george.1@27315.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1528602646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-640-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-640-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "ROBERTO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-31",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023750",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.444842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.