Individual provider Active NPI

Miriam Isabella Gillespie

  • Advanced Practice Midwife
  • Chicago, IL
National Provider Identifier
1699937433
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209004042 Issued in IL
Practice address
800 E 55TH St
Chicago, IL 60615
Phone
(773) 702-0660
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209004042 IL Primary

Addresses

Primary practice location

800 E 55TH St
Chicago, IL 60615

Mailing address

800 E 55TH St
Chicago, IL 60615-4906
Phone (773) 795-2260

Other practice location 1

641 W 63rd St
Chicago, IL 60621-2032
Phone (312) 747-8900

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120328000779 IL Practitioner - Certified Nurse Midwife (CNM) 9335309392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Friend Family Health Center Inc CurrentSince Apr 9, 2018 Accepting new patients
Friend Family Health Center Inc CurrentSince Apr 9, 2018 Accepting new patients
MSMC Investors, LLC Advanced Practice Midwife Past Accepting new patients
Blue Island HBP Medical Group LLC Past Accepting new patients

Locations

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

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

Organizations & group practices 4

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1699937433",
    "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": "773-795-2260"
        },
        {
            "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": "60615",
            "telephone_number": "773-702-0660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 W 63rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606212032",
            "country_code": "US",
            "telephone_number": "312-747-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "MIRIAM",
        "middle_name": "ISABELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209004042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.