Individual provider Active NPI

Eva Madelyn Conty-Cuevas

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1578670428
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209005814 Issued in IL
Practice address
3319 N Elston Ave
Suite #100
Chicago, IL 60618-5811
Phone
(773) 751-7200
Fax
(773) 583-4295
NPI assigned
Aug 25, 2006
Last updated
Apr 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209005814 IL Primary

Addresses

Primary practice location

3319 N Elston Ave
Suite #100
Chicago, IL 60618-5811

Mailing address

3319 N Elston Ave
Suite #100
Chicago, IL 60618-5811
Phone (773) 751-7200

Other identifiers 1

IdentifierTypeStateIssuer
209005814OtherILLICENSE

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
I20061114000142 IL Practitioner - Nurse Practitioner 9739187493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loyola University of Chicago, Stritch School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

333 E Route 83
Suite 203
Mundelein, IL 60060-4279

333 E State Route 83
Suite 203
Mundelein, IL 60060-4279
Phone (847) 979-9095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209005814ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Dona LLC CurrentSince Apr 1, 2019 Accepting new patients
Absolute Dentistry LTD PastSince Jul 1, 2015 Accepting new patients
Lake Mi Mobile Doctors, P.C. Past Accepting new patients
Lake Mi Mobile Doctors, P.C. Past Accepting new patients

Locations

333 E State Route 83
Ste 203
Mundelein, IL 60060
Phone (847) 979-9095

1807 Hicks Rd
Ste A
Rolling Meadows, IL 60008
Phone (414) 533-7503

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, 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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1578670428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE #100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 N ELSTON AVE",
            "address_2": "SUITE #100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185811",
            "telephone_number": "773-751-7200",
            "fax_number": "773-583-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTY-CUEVAS",
        "first_name": "EVA",
        "middle_name": "MADELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209005814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209005814",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.