Individual provider Active NPI

Celine Boers, NP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1750382032
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041183241 Issued in IL
Practice address
4235 W North Ave
Chicago, IL 60639-4852
Phone
(773) 278-6868
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 041183241 IL Primary

Addresses

Primary practice location

4235 W North Ave
Chicago, IL 60639-4852

Mailing address

1427 Forest Ave
Calumet City, IL 60409-6049
Phone (773) 891-2507

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
I20040525000688 IL Practitioner - Nurse Practitioner 9133100316 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primecare Community Health Inc. CurrentSince Mar 22, 2012 Accepting new patients
Primecare Community Health, Inc. Current Accepting new patients
Primecare Community Health, Inc. Current Accepting new patients
Primecare Community Health Inc CurrentSince Mar 22, 2012 Accepting new patients
Primecare Community Health, Inc. Past Accepting new patients

Locations

1431 N Western Ave
Ste 406
Chicago, IL 60622
Phone (312) 491-5495

4235 W North Ave
Chicago, IL 60639
Phone (773) 278-6868

3924 W Fullerton Ave
Chicago, IL 60647
Phone (773) 276-2229

1431 N Western Ave
Ste 209
Chicago, IL 60622
Phone (312) 491-5435

1431 N Western Ave
Ste 202
Chicago, IL 60622
Phone (773) 276-2272

1920 N Hamlin Ave
Chicago, IL 60647
Phone (773) 772-7202

1431 N Western Ave
Ste 401
Chicago, IL 60622
Phone (312) 633-5841

1649 N Pulaski Rd
Chicago, IL 60639
Phone (773) 278-6868

1127 N Oakley Blvd
#2
Chicago, IL 60622

Interoperability endpoints

  • Direct secure messaging: celine.boers.1@16494.direct.athenahealth.com

Organizations & group practices 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750382032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1427 FOREST AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604096049",
            "telephone_number": "773-891-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606394852",
            "telephone_number": "773-278-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERS",
        "first_name": "CELINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041183241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.