Individual provider Active NPI

Anna Lucas, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1780305656
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.025898 Issued in IL
Practice address
3154 N Clark St
Chicago, IL 60657-4437
Phone
(773) 296-7580
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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 209.025898 IL Primary

Addresses

Primary practice location

3154 N Clark St
Chicago, IL 60657-4437

Mailing address

2756 N Pine Grove Ave Apt 406
Chicago, IL 60614-6165
Phone (513) 477-9384

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
I20240709001757 IL Practitioner - Nurse Practitioner 9133580376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

1616 N Damen Ave
Suite 301
Chicago, IL 60647-5536
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.025898ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tapestry 360 Health CurrentSince Oct 8, 2023 Accepting new patients
Edgewood Clinical Services, P.C. Psychiatric/Mental Health CurrentSince Apr 28, 2024 Accepting new patients
Tapestry 360 Health PastSince Sep 11, 2022 Accepting new patients
Psychology Specialists LTD Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

3154 N Clark St
Chicago, IL 60657
Phone (773) 296-7580

1616 N Damen Ave
Ste 301
Chicago, IL 60647
Phone (312) 761-4720

1300 W Devon Ave
Chicago, IL 60660
Phone (773) 751-7850

1301 W Devon Ave
Chicago, IL 60660
Phone (773) 296-7580

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.annalucas@146897.advancedmd-direct.com

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1780305656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2756 N PINE GROVE AVE APT 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146165",
            "telephone_number": "513-477-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574437",
            "telephone_number": "773-296-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ANNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.025898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.