Nicole Fortuna

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036.166344 Issued in IL

Practice address

1801 W Taylor St
Chicago, IL 60612-4795

Phone

(312) 996-7416

NPI assigned

Mar 26, 2015

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nfortuna153095@uihealth.direct-ci.com
• Direct secure messaging: nfortuna354310@direct.ochin.org

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  dba Occupational Health Service Institute (OHSI)

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1093934275
  NPD
• Board of Trustees of the University of Illinois

  dba Medical Service Plan at Peoria

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)
• The Board of Trustees of the University of Illinois

  dba UIC Physician Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1134118649

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1699169664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "312-996-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.166344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699169664",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher A Fortier, MPT
• Emily J Fortman, DPT
• Katie Rose Fortman, DC
• Tyler Fortman
• Quaneisha Fortson, FNP-BC
• John E Fortunato Jr., MD
• Joseph P Fortunato, PSY.D
• Leanna Fortunato, PHD
• Rosemarie Carmel Fortune
• Forum Extended Care SVC Inc II

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.