Individual provider Active NPI

Eleanor Anselmo, CPNP-AC

  • Critical Care Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1639951841
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X
License
209028506 Issued in IL
Practice address
225 E Chicago Ave
Chicago, IL 60611-2991
Phone
(312) 227-1600
NPI assigned
Oct 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 209028506 IL Primary

Addresses

Primary practice location

225 E Chicago Ave
Chicago, IL 60611-2991

Mailing address

873 N Larrabee St Apt 402
Chicago, IL 60610-8906

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

225 E Chicago Ave
Chicago, IL 60611-2991

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209028506ILMDCritical Care Pediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1639951841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 N LARRABEE ST APT 402",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSELMO",
        "first_name": "ELEANOR",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "IL",
            "license": "209028506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.