Individual provider Active NPI

Carrie Daly, APN

  • Nurse Practitioner
  • Elmhurst, IL
National Provider Identifier
1821406257
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209004567 Issued in IL
Practice address
420 W Butterfield Rd
Elmhurst, IL 60126-4980
Phone
(630) 310-6505
Fax
(331) 221-2706
NPI assigned
Jul 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 209004567 IL Primary

Addresses

Primary practice location

420 W Butterfield Rd
Elmhurst, IL 60126-4980

Mailing address

1200 S York St Ste 2000
Elmhurst, IL 60126-5634
Phone (331) 221-5678

Other identifiers 1

IdentifierTypeStateIssuer
421533176001MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdaly47067@direct.edward.org Direct

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
I20140919002382 IL Practitioner - Nurse Practitioner 1850510017 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 20, 2014 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince Jan 20, 2015 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 20, 2014 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Wyse Eyecare SC Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

9532 Eagle Way
Chicago, IL 60678

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

420 W Butterfield Rd
Elmhurst, IL 60126
Phone (630) 832-2300

1200 S York St
Ste 2000
Elmhurst, IL 60126
Phone (331) 221-9002

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

4201 Winfield Rd
Fl 3
Warrenville, IL 60555

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Interoperability endpoints

  • Direct secure messaging: cdaly47067@direct.edward.org

Organizations & group practices 6

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": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1821406257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST STE 2000",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265634",
            "telephone_number": "331-221-5678",
            "fax_number": "331-221-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W BUTTERFIELD RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601264980",
            "telephone_number": "630-310-6505",
            "fax_number": "331-221-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "CARRIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-29",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209004567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421533176001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdaly47067@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "420 W Butterfield Rd",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601264980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.