Daniel Ceballos, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209-003925 Issued in IL

Practice address

3600 W Fullerton Ave
Chicago, IL 60647-2319

Phone

(773) 782-2800

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1659449767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 W HARRISON ST APT 4",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123788",
            "telephone_number": "312-421-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 S Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606122706",
            "country_code": "US",
            "telephone_number": "312-746-7335",
            "fax_number": "312-746-9049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEBALLOS",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-003925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.ceballos.1@17986.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3600 W Fullerton Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606472319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• CDN Surgical Assoc., LTD.
• Cdpsyd L.L.C.
• Lauren Cea, DO
• Iniko Makula Ceaser
• Sheldon T Ceaser, M.D.
• Natasha D Ceballos, LCSW
• Martina Cebollero, OTR/L
• Maria Cebrero
• Marcin Cebula
• Russell J. Cecala, D.D.S., M.S.

• Adult Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.