Organization Active NPI

Rooted Rose Health & Wellness Collective PLLC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1588576557
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ROOTED ROSE HEALTH & WELLNESS COLLECTIVE PLLC
Practice address
11716 S Loomis St
Chicago, IL 60643-5037
Phone
(773) 310-0110
NPI assigned
Sep 22, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Authorized official

Name
Jovan Butler, APRN
Title
Manager
Phone
(773) 310-0110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

11716 S Loomis St
Chicago, IL 60643-5037

Mailing address

1440 W Taylor St Ste 734
Chicago, IL 60607-4623

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790035200000",
    "number": "1588576557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 W TAYLOR ST STE 734",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11716 S LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606435037",
            "telephone_number": "773-310-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED ROSE HEALTH & WELLNESS COLLECTIVE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "JOVAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-310-0110",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.