Individual provider Active NPI

Nancy J Chaiken, APN-C

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1639316334
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209.007291 Issued in IL
Practice address
5145 N California Ave
Wound Care Center
Chicago, IL 60625-3661
Phone
(773) 878-8200
NPI assigned
Jan 16, 2009
Last updated
Mar 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209.007291 IL Primary

Addresses

Primary practice location

5145 N California Ave
Wound Care Center
Chicago, IL 60625-3661

Mailing address

2740 W Foster Ave
LL7
Chicago, IL 60625-3500
Phone (773) 878-8200

Other identifiers 2

IdentifierTypeStateIssuer
406120003OtherPTAN
041177044MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.007291ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Covenant Management Services, Inc. CurrentSince Mar 15, 2009 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Mar 15, 2009 Accepting new patients

Locations

2740 W Foster Ave
Ste 310
Chicago, IL 60625

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

5145 N California Ave
Chicago, IL 60625
Phone (773) 989-3800

Organizations & group practices 2

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": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425254400000",
    "number": "1639316334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "LL7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253500",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE",
            "address_2": "WOUND CARE CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "773-878-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIKEN",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2015-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.007291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "406120003",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041177044",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.