Zeruya Gaddam, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209028493 Issued in IL

Practice address

430 E 162ND St # 487
South Holland, IL 60473-2258

Phone

(708) 960-4280

Fax

(708) 816-0023

NPI assigned

Jun 4, 2024

Sex

Female

Sole proprietor

No

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.

• County of Lake

  • Public Health or Welfare Agency
  • Waukegan, IL
  • NPI 1013920750
  Medicare reassignment Care Compare group NPD IL
• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Willowbrook, IL
  • NPI 1548692890
  Medicare reassignment NPD IL
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Round Lake, IL
  • NPI 1639588254
  Care Compare group NPD
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Zion, IL
  • NPI 1023047164
  Care Compare group NPD (past)
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • North Chicago, IL
  • NPI 1083643118
  Care Compare group
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1174552293
  Care Compare group
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1235453309
  Care Compare group
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Highland Park, IL
  • NPI 1285663328
  Care Compare group
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Libertyville, IL
  • NPI 1679900229
  Care Compare group
• County of Lake

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waukegan, IL
  • NPI 1720290091
  Care Compare group
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Round Lake Beach, IL
  • NPI 1750310884
  Care Compare group
• County of Lake

  • Federally Qualified Health Center (FQHC)
  • Waukegan, IL
  • NPI 1992155022
  Care Compare group
• County of Lake

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukegan, IL
  • NPI 1174745160
  NPD
• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1659952554
  NPD

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

• Northwestern Lake Forest Hospital

  • General Acute Care Hospital
  • Lake Forest, IL
  • NPI 1124025176
  Care Compare affiliation Hospital

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of Lake 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zeruya.gaddam.p1@direct.lakecountyil.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 9, 2025.

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1578304366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E 162ND ST # 487",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732258",
            "telephone_number": "708-960-4280",
            "fax_number": "708-816-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E 162ND ST # 487",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732258",
            "telephone_number": "708-960-4280",
            "fax_number": "708-816-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADDAM",
        "first_name": "ZERUYA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in South Holland, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.