Individual provider Active NPI

Irma E Funes, ANP

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1578817003
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009925 Issued in IL
Practice address
8950 Gross Point Rd
Ste. 300
Skokie, IL 60077-1886
Phone
(847) 965-1901
Fax
(847) 965-1952
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209-009925 IL
Nurse Practitioner 363L00000X 209009925 IL Primary

Addresses

Primary practice location

8950 Gross Point Rd
Ste. 300
Skokie, IL 60077-1886

Mailing address

5341 Carol St
Skokie, IL 60077-2002
Phone (847) 965-1901

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
I20130415000407 IL Practitioner - Nurse Practitioner 0941446009 Reassigns benefits to 2 organizations
Practice locations: Skokie, IL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1440 Renaissance Dr
Suite 125
Park Ridge, IL 60068-1414
Phone (847) 722-4901

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-009925ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District CurrentSince Nov 1, 2020 Accepting new patients
McDonough County Hospital District CurrentSince Nov 1, 2020 Accepting new patients
Bridgeway Behavioral Health LLC CurrentSince Jan 1, 2022 Accepting new patients
Willoughby Center for Behavioral Health, LLC PastSince Mar 9, 2022 Accepting new patients
Wellbound of Evanston LLC PastSince Apr 1, 2007 Accepting new patients

Locations

503 E Grant St
Macomb, IL 61455
Phone (309) 833-5917

1440 Renaissance Dr
Ste 125
Park Ridge, IL 60068
Phone (224) 585-3312

Organizations & group practices 5

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": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1578817003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5341 CAROL ST",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772002",
            "telephone_number": "847-965-1901",
            "fax_number": "847-965-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 GROSS POINT RD",
            "address_2": "STE. 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771886",
            "telephone_number": "847-965-1901",
            "fax_number": "847-965-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNES",
        "first_name": "IRMA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-009925",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.