Shannon Lyn Bartolucci, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209.004191 Issued in IL

Practice address

1909 Ogden Ave Ste a
Downers Grove, IL 60515-2602

Phone

(630) 832-1775

Fax

(630) 832-1775

NPI assigned

Jan 19, 2011

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Lyn Chejfec Other name

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

Specialty

Nurse Practitioner

Education

Rush Medical College of Rush University, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Hub LLCGroup PAC ID 3274817481, 16 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

70.01

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Health Hub, LLC

  • Geriatric Psychiatry Physician
  • Downers Grove, IL
  • NPI 1598203390
  Medicare reassignment Care Compare group NPD
• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946
  Medicare reassignment NPD
• Synapse Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Glen Ellyn, IL
  • NPI 1164366506
  NPD Authorized official
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1770888901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 ANTHONY ST",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374419",
            "telephone_number": "630-864-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 OGDEN AVE STE A",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152602",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTOLUCCI",
        "first_name": "SHANNON",
        "middle_name": "LYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.004191",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.004191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CHEJFEC",
            "middle_name": "LYN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Thomas Paul Barrett, LPC
• Jennifer Barrios, LPC
• Barry Sadegi, M.D., S.C.
• Lisa Bartik, CCC-SLP
• Kailani Marie Bartley
• Basciano and Associates
• Marcia Basciano, DDS
• Kathryn Kellogg Basco
• Maryann Basista, LCSW
• Emaad Basith, MD

• Gerontology Nurse Practitioner in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.