Individual provider Active NPI

Emily Therese Opiola, FNP-C

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1790270965
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.017833 Issued in IL
Practice address
12816 S Muskegon Ave
Chicago, IL 60633-1243
Phone
(630) 310-6212
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.017833 IL Primary

Addresses

Primary practice location

12816 S Muskegon Ave
Chicago, IL 60633-1243

Mailing address

12816 S Muskegon Ave
Chicago, IL 60633-1243
Phone (630) 310-6212

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
I20190328001295 IL Practitioner - Nurse Practitioner 5991045908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

900 E 103Rd St
Chicago, IL 60628-3033
Phone (773) 468-2963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.017833ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Illinois PC CurrentSince Feb 6, 2019 Accepting new patients

Locations

900 E 103rd St
Chicago, IL 60628
Phone (773) 468-2963

10137 Grand Ave
Franklin Park, IL 60131
Phone (847) 451-7590

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 1

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1790270965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12816 S MUSKEGON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606331243",
            "telephone_number": "630-310-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12816 S MUSKEGON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606331243",
            "telephone_number": "630-310-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPIOLA",
        "first_name": "EMILY",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.