Individual provider Active NPI

Chelsea Alysse Bianca, APN

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1659851913
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2019034346 Issued in MO
Practice address
9977 Woods Dr
Skokie, IL 60077-1057
Phone
(224) 364-2273
NPI assigned
Aug 16, 2018
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.017623 IL
Nurse Practitioner 363L00000X 2019034346 MO Primary
Registered Nurse 163W00000X 041426197 IL

Addresses

Primary practice location

9977 Woods Dr
Skokie, IL 60077-1057

Mailing address

9977 Woods Dr
Skokie, IL 60077-1057
Phone (224) 364-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180911001729 IL Practitioner - Nurse Practitioner 6507116654 Reassigns benefits to 1 organization
I20200219001305 MO Practitioner - Nurse Practitioner 6507116654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine of St Lukes LLCGroup PAC ID 0042360075, 7 clinicians
Elite Physical Therapy of Creve Coeur LLCGroup PAC ID 7719280841, 85 clinicians

Practice addresses (Care Compare)

121 Saint Lukes Ctr Dr
Chesterfield, MO 63017-3519
Phone (314) 682-3625

12788 Olive Blvd
Creve Coeur, MO 63141-6211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.71 of 100Reported as apm
Quality
82.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041426197ILMDRegistered Nurse
209.017623ILMDNurse Practitioner
2019034346MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 22, 2018 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 22, 2018 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

9977 Woods Dr
Skokie, IL 60077
Phone (847) 663-8540

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1659851913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCA",
        "first_name": "CHELSEA",
        "middle_name": "ALYSSE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.017623",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2019034346",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041426197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.