Active NPI
Matt Vatanatunyakum
- Family Nurse Practitioner
- Schaumburg, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209025739
- Practice address
- 519 S Roselle Rd
Schaumburg, IL 60193-2925 - Phone
- (847) 985-0600
- Fax
- (847) 985-3786
- NPI assigned
- Aug 31, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209025739 | IL | Primary |
Addresses
Primary practice location
519 S Roselle Rd
Schaumburg, IL 60193-2925
Mailing address
519 S Roselle Rd
Schaumburg, IL 60193-2925
Phone (847) 985-0600
Other practice location 1
5700 S Maryland Ave
Chicago, IL 60637-1426
Phone (888) 824-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209025739 | Other | IL | STATE LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | mvatan2@uic.edu | 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1309 S Halsted St
Chicago, IL 60607-5003
Phone (312) 413-3000
Hospital & facility affiliations
- University of Illinois Hospital and Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.28 of 100
- Quality
- 73.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.73
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Northwest Community Health Services Inc | Current | Accepting new patients | |
| Northwest Community Health Services Inc | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Board of Trustees of the University of Illinois | Past | Accepting new patients | |
| Endeavor Health Medical Group | Past | Accepting new patients |
Locations
3040 W Salt Creek Ln
Arlington Heights, IL 60005
Phone (847) 618-3481
1051 W Rand Rd
Arlington Hts, IL 60004
Phone (847) 221-4601
1450 Busch Pkwy
Buffalo Grove, IL 60089
Phone (847) 459-7860
1309 S Halsted St
Chicago, IL 60607
Phone (312) 413-3000
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290
25233 Network Pl
Chicago, IL 60673
7732 Solutions Ctr
Chicago, IL 60677
845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295
1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700
21481 N Rand Rd
Kildeer, IL 60047
Phone (847) 618-9696
519 S Roselle Rd
Schaumburg, IL 60193
Phone (847) 618-0535
Interoperability endpoints
- mvatanatunyakum96426@uihealth.direct-ci.com
Organizations & group practices 7
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.
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
- Internal Medicine Physician
- Arlington Heights, IL
- NPI 1134433154
-
- Obstetrics Physician
- Arlington Heights, IL
- NPI 1467057513
-
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1609094739
-
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
-
- Anesthesiology Physician
- Evanston, IL
- NPI 1265695944
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1861431751
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668643200000",
"number": "1821766221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 S ROSELLE RD",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601932925",
"telephone_number": "847-985-0600",
"fax_number": "847-985-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "519 S ROSELLE RD",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601932925",
"telephone_number": "847-985-0600",
"fax_number": "847-985-3786"
}
],
"practiceLocations": [
{
"address_1": "5700 S Maryland Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606371426",
"country_code": "US",
"telephone_number": "888-824-0200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VATANATUNYAKUM",
"first_name": "MATT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-31",
"last_updated": "2022-11-17",
"certification_date": "2022-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209025739",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "209025739",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "mvatan2@uic.edu",
"affiliation": "N",
"endpointDescription": "school",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "other",
"address_1": "5700 S. Maryland Ave",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "60637",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.