Individual provider Active NPI

Angela D Rogers, FNP, MSN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1679503429
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-004974 Issued in IL
Practice address
1541 W Devon Ave
Chicago, IL 60660-1313
Phone
(773) 250-5222
Fax
(773) 866-8018
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209-004974 IL Primary

Addresses

Primary practice location

1541 W Devon Ave
Chicago, IL 60660-1313

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (312) 733-9730

Other practice location 1

680 N Lake Shore Dr
Suite 818
Chicago, IL 60611-4546
Phone (312) 926-6146

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
I20240605003643 IL Order and Referring Only - Nurse Practitioner 8628072774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-004974ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Memorial Physicians Group Past Accepting new patients
Northwestern Memorial Physicians Group Past Accepting new patients
Horizon Hospice and Palliative Care Inc PastSince Sep 5, 2013 Accepting new patients

Organizations & group practices 3

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1679503429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606601313",
            "telephone_number": "773-250-5222",
            "fax_number": "773-866-8018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 N Lake Shore Dr",
            "address_2": "Suite 818",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114546",
            "country_code": "US",
            "telephone_number": "312-926-6146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "ANGELA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "FNP, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-004974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.