Individual provider Active NPI

Debora Delre, APN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1780048058
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209014185 Issued in IL
Practice address
640 S Washington St
Naperville, IL 60540-6603
Phone
(815) 942-6323
Fax
(779) 210-5541
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209014185 IL Primary

Addresses

Primary practice location

640 S Washington St
Naperville, IL 60540-6603

Mailing address

PO Box 713260
Chicago, IL 60677-0264
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
F400292315OtherILMEDICARE PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddelre218254@dulyhealthandcare.direct-ci.com Direct

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
I20160429000354 IL Practitioner - Nurse Practitioner 9436458247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jan 1, 2022 Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 1, 2022 Accepting new patients

Locations

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

1401 Lakewood Dr
Ste A
Morris, IL 60450

640 S Washington St
Naperville, IL 60540
Phone (630) 428-1500

12251 S 80th Ave
Palos Heights, IL 60463
Phone (708) 361-4500

25 N Winfield Rd
Ste 300
Winfield, IL 60190
Phone (630) 933-8100

Interoperability endpoints

  • Direct secure messaging: ddelre218254@dulyhealthandcare.direct-ci.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.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1780048058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770264",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406603",
            "telephone_number": "815-942-6323",
            "fax_number": "779-210-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELRE",
        "first_name": "DEBORA",
        "credential": "APN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209014185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "F400292315",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddelre218254@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "640 S Washington St",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.