Nicole Marie Chum, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.025606 Issued in IL

Practice address

920 West St Ste 216
Peru, IL 61354-2769

Phone

(309) 451-3376

Fax

(309) 452-3376

NPI assigned

Aug 5, 2022

Last updated

Aug 5, 2022By 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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Mohs Surgery Institute LTDGroup PAC ID 3870732191, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• Osf Saint Clare Medical Center Hospital, Princeton, IL, CCN 141337

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dermatology and Mohs Surgery Institute, LTD.

  • Specialist
  • Bloomington, IL
  • NPI 1770828626
  Medicare reassignment Care Compare group NPD
• Carle Bromenn Medical Center

  dba Advocate BroMenn Medical Center

  • General Acute Care Hospital
  • Normal, IL
  • NPI 1962424036
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  dba OSF Saint Clare Medical Center

  • Critical Access Hospital
  • Princeton, IL
  • NPI 1093308439
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1699402016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1986 N 2919TH RD",
            "city": "MARSEILLES",
            "state": "IL",
            "postal_code": "613419002",
            "telephone_number": "815-343-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 WEST ST STE 216",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542769",
            "telephone_number": "309-451-3376",
            "fax_number": "309-452-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUM",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Michael Ceresa, D.D.S.
• Chicago Hearing LLC
• Dale R Chilson, D.O
• Catherine A Christensen, RN, WHCNP, CNM
• Keith Christensen, APN, FNP
• City Center Physical Therapy - Peru, Inc.
• City Center Rehabilitation West - Inc.
• CMS & S LTD. (Home Instead Senior Care 536)
• Julie A Condie, MOT,OTR/L
• Constantino Perales Jr., M.D. (Seventh Street Clinic)

• Family Nurse Practitioner in Peru, IL
• Providers in Peru, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.