Individual provider Active NPI

Jenica Sidler, APP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1801469036
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022173 Issued in IL
Practice address
710 S Paulina St Ste JRB 600
Chicago, IL 60612-3808
Phone
(312) 942-5000
NPI assigned
Jul 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022173 IL Primary

Addresses

Primary practice location

710 S Paulina St Ste JRB 600
Chicago, IL 60612-3808

Mailing address

710 South Paulina Street
Suite JRB 600
Chicago, IL 60612-3808
Phone (312) 942-5000

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
I20211015000217 IL Practitioner - Nurse Practitioner 6901204361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rush University Medical Group 1,521 clinicians

Practice addresses (Care Compare)

710 S Paulina St
Suite 600
Chicago, IL 60612-3808
Phone (312) 942-5440

Hospital & facility affiliations

  • Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063
  • Rush University Medical Center Hospital, Chicago, IL, CCN 140119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Oct 4, 2021 Accepting new patients
Rush University Medical Group CurrentSince Oct 4, 2021 Accepting new patients

Locations

710 S Paulina St
Ste 600
Chicago, IL 60612
Phone (312) 942-5440

710 S Paulina St
Ste Jrb
Chicago, IL 60612

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

2011 York Rd
Ste 2000A
Oak Brook, IL 60523
Phone (312) 947-7546

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1627084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1801469036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 SOUTH PAULINA STREET",
            "address_2": "SUITE JRB 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123808",
            "telephone_number": "312-942-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S PAULINA ST STE JRB 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123808",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDLER",
        "first_name": "JENICA",
        "name_prefix": "Mrs.",
        "credential": "APP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-24",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.