Individual provider Active NPI

Mary Catherin Vercellino, RN, APN, CNS

  • Adult Health Clinical Nurse Specialist
  • Naperville, IL
National Provider Identifier
1760767966
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
209009086 Issued in IL
Practice address
801 S Washington St
Naperville, IL 60540-7430
Phone
(630) 527-3070
NPI assigned
Oct 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 209009086 IL Primary

Addresses

Primary practice location

801 S Washington St
Naperville, IL 60540-7430

Mailing address

801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-3070

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
I20140818002692 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 4486871209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
209009086ILMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 24, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 1, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 24, 2023 Accepting new patients
Edward Health Ventures CurrentSince Aug 1, 2014 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

24600 W 127th St
Ste B100
Plainfield, IL 60585
Phone (815) 731-9000

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": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1760767966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407430",
            "telephone_number": "630-527-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407430",
            "telephone_number": "630-527-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERCELLINO",
        "first_name": "MARY",
        "middle_name": "CATHERIN",
        "name_prefix": "Ms.",
        "credential": "RN, APN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209009086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.