Individual provider Active NPI

Jac Guerra, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1841183407
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.033039 Issued in IL
Practice address
927 W Irving Park Rd
Chicago, IL 60613-2597
Phone
(203) 494-6397
NPI assigned
Jun 2, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.033039 IL Primary

Addresses

Primary practice location

927 W Irving Park Rd
Chicago, IL 60613-2597

Mailing address

927 W Irving Park Rd
Chicago, IL 60613-2597
Phone (203) 494-6397

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
I20251118003538 IL Practitioner - Nurse Practitioner 1658862586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Anthony Health AffiliatesGroup PAC ID 1254321474, 95 clinicians

Practice addresses (Care Compare)

2875 W 19TH St
Chicago, IL 60623-3501
Phone (773) 484-4425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.033039ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Anthony Health Affiliates Psychiatric/Mental Health CurrentSince Oct 1, 2025 Accepting new patients
Saint Anthony Health Affiliates CurrentSince Oct 1, 2025 Accepting new patients

Locations

2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300

4177 S Archer Ave
Chicago, IL 60632
Phone (773) 254-2222

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.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1841183407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132597",
            "telephone_number": "203-494-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132597",
            "telephone_number": "203-494-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "JAC",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.033039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.