Individual provider Active NPI

Miesha Thomas

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1538889092
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209025399 Issued in IL
Practice address
1329 W 97TH St
Chicago, IL 60643-1417
Phone
(773) 879-0291
NPI assigned
Sep 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209025399 IL Primary

Addresses

Primary practice location

1329 W 97TH St
Chicago, IL 60643-1417

Mailing address

1329 W 97TH St
Chicago, IL 60643-1417
Phone (773) 879-0291

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
I20230123002417 IL Practitioner - Nurse Practitioner 8022489442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Practice addresses (Care Compare)

10834 B S Doty Ave
Chicago, IL 60628-3802
Phone (708) 922-0911

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Jan 23, 2023 Accepting new patients
Illinois Urgent Care Professionals PLLC CurrentSince Jan 7, 2026 Accepting new patients
Community Health Providers PLLC PastSince Jan 7, 2026 Accepting new patients

Locations

10834B S Doty Ave
Chicago, IL 60628
Phone (773) 995-9911

600 W Adams St
Chicago, IL 60661
Phone (312) 506-0900

6140 N Broadway St
Chicago, IL 60660
Phone (224) 795-3521

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

1009 Fairway Dr
Freeport, IL 61032
Phone (815) 986-4200

7444 W Wilson Ave
Ste 102
Harwood Hts, IL 60706
Phone 2249996997101

17960 Halsted St
Homewood, IL 60430
Phone (708) 923-0911

9701 W Higgins Rd
Ste 270
Rosemont, IL 60018
Phone (847) 653-0130

Organizations & group practices 4

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": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1538889092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 W 97TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431417",
            "telephone_number": "773-879-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 W 97TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431417",
            "telephone_number": "773-879-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MIESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209025399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.