Individual provider Active NPI

Julienne N Kebi

  • Nurse Practitioner
  • Wheaton, IL
National Provider Identifier
1700616521
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.030151 Issued in IL
Practice address
1910 E Roosevelt Rd
Wheaton, IL 60187-6955
Phone
(331) 866-1013
NPI assigned
Aug 6, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.030151 IL Primary

Addresses

Primary practice location

1910 E Roosevelt Rd
Wheaton, IL 60187-6955

Mailing address

2019 Charlela LN Apt 211
211
Elk Grove Village, IL 60007
Phone (919) 806-6958

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
I20240830001290 IL Practitioner - Nurse Practitioner 3678012978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.030151ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Jul 29, 2024 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jul 29, 2024 Accepting new patients

Locations

1910 E Roosevelt Rd
Wheaton, IL 60187
Phone (331) 866-1013

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1700616521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 CHARLELA LN APT 211",
            "address_2": "211",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "60007",
            "telephone_number": "919-806-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 E ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876955",
            "telephone_number": "331-866-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBI",
        "first_name": "JULIENNE",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.030151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.