NPIMap

Organization Active NPI

Advanced Practice Network, LLC

  • Clinic/Center
  • Chicago, IL
National Provider Identifier
1790401701
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ADVANCED PRACTICE NETWORK, LLC
Doing business as
Advanced Practice Network, LLC
Practice address
1444 W 74TH St
Chicago, IL 60636-4028
Phone
(773) 709-6679
NPI assigned
Oct 12, 2022
Last updated
May 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Authorized official

Name
Shelia Lavette Martin, FNP-BCNPI 1154820413
Title
President
Phone
(773) 709-6679

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1444 W 74TH St
Chicago, IL 60636-4028

Mailing address

1444 W 74TH St
Chicago, IL 60636-4028
Phone (773) 709-6679

Other identifiers 1

IdentifierTypeStateIssuer
1154820413OtherILNPI TYPE 1

Other names 1

  • Advanced Practice Network, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230501000104 IL Part B Supplier - Clinic/Group Practice 6305201161 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1790401701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 W 74TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606364028",
            "telephone_number": "773-709-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1444 W 74TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606364028",
            "telephone_number": "773-709-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PRACTICE NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_middle_name": "LAVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-709-6679",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1154820413",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Practice Network, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Practice Network, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.