Individual provider Active NPI

Brian Medley, APN-CNP

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1689522310
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209035035 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2000
NPI assigned
Mar 18, 2026
Last updated
Mar 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209035035 IL Primary
Acute Care Nurse Practitioner 363LA2100X 209.035035 IL

Addresses

Primary practice location

2650 Ridge Ave
Evanston, IL 60201-1700

Mailing address

2650 Ridge Ave
Suite 1223
Evanston, IL 60201-1700
Phone (847) 570-2428

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
I20260403001561 IL Practitioner - Nurse Practitioner 5395220651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2650 Ridge Ave
Suite 1223
Evanston, IL 60201-1700

2650 Ridge Ave
Suite 1223
Evanston, IL 60201-1797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209035035ILMDNurse Practitioner
209.035035ILMDAcute Care Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1689522310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "SUITE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "BRIAN",
        "credential": "APN-CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209035035",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.035035",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.