Individual provider Active NPI

Theresa Schafer Nuestro, P.A.

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1750531166
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085003065 Issued in IL
Practice address
1725 W Harrison St
Suite 1010
Chicago, IL 60612-3841
Phone
(312) 942-6300
Fax
(312) 942-6301
NPI assigned
Sep 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085003065 IL Primary

Addresses

Primary practice location

1725 W Harrison St
Suite 1010
Chicago, IL 60612-3841

Mailing address

1725 W Harrison St
Suite 848
Chicago, IL 60612-3841
Phone (312) 942-6300

Other identifiers 1

IdentifierTypeStateIssuer
085003065OtherILDEPT. OF PROFESSIONAL REGULATION

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
I20130703000222 IL Practitioner - Physician Assistant 6305086968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

1520 W Harrison St
Chicago, IL 60607-3106
Phone (312) 942-5904

1700 W Van Buren St
Chicago, IL 60612-5500
Phone (312) 563-2875

210 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (312) 942-6300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group CurrentSince Oct 1, 2020 Accepting new patients
Midwest Podiatry Services LTD Past Accepting new patients

Locations

210 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 318-9350

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 842
Chicago, IL 60612
Phone (312) 723-0930

1725 W Harrison St
Ste 1010
Chicago, IL 60612
Phone (312) 942-5904

1725 W Harrison St
Ste 848
Chicago, IL 60612
Phone (312) 563-2090

1520 W Harrison St
Chicago, IL 60607
Phone (312) 226-2371

5140 N California Ave
Ste 635645
Chicago, IL 60625
Phone (773) 989-6200

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 351
Chicago, IL 60612
Phone (312) 226-2371

1170 E Belvidere Rd
Ste 102
Grayslake, IL 60030
Phone (847) 548-2200

3900 W 203rd St
Olympia Flds, IL 60461
Phone (708) 478-7437

16011 108th Ave
Orland Park, IL 60467
Phone (708) 364-0870

Interoperability endpoints

  • Direct secure messaging: tnuestro58047@direct.rush.rush-health.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1750531166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 848",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-6300",
            "fax_number": "312-942-6301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "SUITE 1010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-942-6300",
            "fax_number": "312-942-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUESTRO",
        "first_name": "THERESA",
        "middle_name": "SCHAFER",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-22",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF PROFESSIONAL REGULATION",
            "identifier": "085003065",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.