Individual provider Active NPI

Tomasa Valencia, APRN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1790337228
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018422 Issued in IL
Practice address
1945 W Wilson Ave
Chicago, IL 60640
Phone
(773) 878-6600
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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 209018422 IL Primary

Addresses

Primary practice location

1945 W Wilson Ave
Chicago, IL 60640

Mailing address

1945 W Wilson Ave Ste 5110
Chicago, IL 60640-5258
Phone (773) 878-6600

Other practice location 1

1044 N Francisco Ave
Chicago, IL 60622-2743
Phone (773) 292-8200

Other practice location 2

1945 W Wilson Ave
Chicago, IL 60640
Phone (773) 878-6600

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chicago

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
I20200923000087 IL Practitioner - Nurse Practitioner 1052730140 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209018422ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt Park Health CurrentSince May 2, 2020 Accepting new patients

Locations

1044 N Mozart St
Ste 100
Chicago, IL 60622
Phone (773) 292-8247

1044 N Francisco Ave
Chicago, IL 60622
Phone (773) 292-8227

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1790337228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE STE 5110",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405258",
            "telephone_number": "773-878-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-878-6600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 N Francisco Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606222743",
            "country_code": "US",
            "telephone_number": "773-292-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1945 W Wilson Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60640",
            "country_code": "US",
            "telephone_number": "773-878-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "TOMASA",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "address_1": "1945 W Wilson Ave Ste 5110",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606405258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.