Individual provider Active NPI

Theresa A Flerick, N.P.

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1689770695
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209000506 Issued in IL
Practice address
800 E 55TH St
Chicago, IL 60615-4906
Phone
(773) 702-0660
Fax
(773) 702-4356
NPI assigned
Sep 16, 2006
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 209000506 IL Primary

Addresses

Primary practice location

800 E 55TH St
Chicago, IL 60615-4906

Mailing address

800 E 55TH St
Chicago, IL 60615-4906
Phone (773) 702-0660

Other identifiers 1

IdentifierTypeStateIssuer
209000506OtherILLICENSE

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
I20131022002013 IL Practitioner - Nurse Practitioner 8123253457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Friend Family Health Center IncGroup PAC ID 2062494552, 36 clinicians

Practice addresses (Care Compare)

6250 S Cottage Grove Ave
Chicago, IL 60637-2530
Phone (773) 702-0660

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Friend Family Health Center Inc CurrentSince Jan 1, 2013 Accepting new patients
Friend Family Health Center Inc CurrentSince Jan 1, 2013 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients

Locations

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

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, 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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1689770695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154906",
            "telephone_number": "773-702-0660",
            "fax_number": "773-702-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154906",
            "telephone_number": "773-702-0660",
            "fax_number": "773-702-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLERICK",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209000506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209000506",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.