Individual provider Active NPI

Leticia Mota

  • Critical Care Neonatal Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1699011189
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
209009409 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone
(888) 824-0200
NPI assigned
Jan 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 209009409 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1443

Mailing address

150 Harvester Dr
Suite 300
Burr Ridge, IL 60527-5919

Other names 1

  • Leticia Lemus Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address llemusapn14136@uchospital.direct-ci.com University of Chicago Physicians Group

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
I20130628000182 IL Practitioner - Nurse Practitioner 4880834621 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Oct 30, 2021 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System Current Accepting new patients
The University of Chicago Medical Center CurrentSince May 28, 2024 Accepting new patients
Osf Healthcare System CurrentSince Oct 13, 2020 Accepting new patients
University of Chicago CurrentSince Apr 24, 2013 Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 30, 2021 Accepting new patients
Osf Healthcare System CurrentSince Oct 13, 2020 Accepting new patients
The University of Chicago Medical Center CurrentSince May 28, 2024 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

2800 W 95th St
Evergreen Pk, IL 60805
Phone (708) 229-5104

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

1000 W Harlem Ave
Monmouth, IL 61462
Phone (309) 734-1414

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Interoperability endpoints

  • Direct secure messaging: llemusapn14136@uchospital.direct-ci.com

Organizations & group practices 9

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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1699011189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 HARVESTER DR",
            "address_2": "SUITE 300",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "888-824-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTA",
        "first_name": "LETICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "IL",
            "license": "209009409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llemusapn14136@uchospital.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "University of Chicago Physicians Group",
            "address_1": "5841 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LETICIA",
            "last_name": "LEMUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.