Individual provider Active NPI

Maria R Reyes, PHD, WHNP, CNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1548494255
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
209.001736 Issued in IL
Practice address
1645 W Jackson Blvd
Chicago, IL 60612-3276
Phone
(312) 942-2777
Fax
(312) 942-2822
NPI assigned
May 8, 2009
Last updated
Dec 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 209.001736 IL Primary

Addresses

Primary practice location

1645 W Jackson Blvd
Chicago, IL 60612-3276

Mailing address

10824 S Kolmar Ave
Oak Lawn, IL 60453-5619
Phone (708) 424-0053

Other identifiers 2

IdentifierTypeStateIssuer
209.001736OtherILAPN LICENSURE
REY104282734OtherILNCC CERTIFICATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
209.001736ILMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mreyes8654@direct.rush.rush-health.com

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, 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": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1548494255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10824 S KOLMAR AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535619",
            "telephone_number": "708-424-0053",
            "fax_number": "312-942-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123276",
            "telephone_number": "312-942-2777",
            "fax_number": "312-942-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MARIA",
        "middle_name": "R",
        "credential": "PHD, WHNP, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209.001736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSURE",
            "identifier": "209.001736",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC CERTIFICATION",
            "identifier": "REY104282734",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.