Individual provider Active NPI

Bernadette Carmel Namatovu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • McHenry, IL
National Provider Identifier
1639945272
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209029229 Issued in IL
Practice address
4609 W Shore Dr
McHenry, IL 60050-3783
Phone
(815) 670-8265
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209029229 IL Primary

Addresses

Primary practice location

4609 W Shore Dr
McHenry, IL 60050-3783

Mailing address

4609 W Shore Dr
McHenry, IL 60050-3783
Phone (815) 670-8265

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
I20240614001855 IL Practitioner - Nurse Practitioner 8022551324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMS Clinical Services PLLCGroup PAC ID 7517395064, 30 clinicians

Practice addresses (Care Compare)

815 W Van Buren St
Suite 302
Chicago, IL 60607-3593
Phone (630) 974-6602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209029229ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMS Clinical Services PLLC CurrentSince Jun 4, 2024 Accepting new patients
Relief Mental Health PastSince Dec 6, 2020 Accepting new patients

Locations

3264 N Clark St
Chicago, IL 60657

815 W Van Buren St
Ste 302
Chicago, IL 60607

899 Skokie Blvd
Ste 260
Northbrook, IL 60062
Phone (630) 970-6602

1100 Jorie Blvd
Ste 300
Oak Brook, IL 60523
Phone (224) 900-7867

14300 S Ravinia Ave
Ste 100
Orland Park, IL 60462
Phone (855) 205-4764

1641 N Alpine Rd
Ste 207
Rockford, IL 61107

409 Illinois Ave
Unit 1D
St Charles, IL 60174
Phone (855) 205-4764

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1639945272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 W SHORE DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600503783",
            "telephone_number": "815-670-8265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 W SHORE DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600503783",
            "telephone_number": "815-670-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMATOVU",
        "first_name": "BERNADETTE",
        "middle_name": "CARMEL",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.