Individual provider Active NPI

Jennifer Dawn Baralli, A.P.N.

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1851737548
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209005363 Issued in IL
Practice address
259 E Erie St FL 17
Chicago, IL 60611-2987
Phone
(312) 926-6000
Fax
(312) 926-0516
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.005363 IL
Nurse Practitioner 363L00000X 209005363 IL Primary

Addresses

Primary practice location

259 E Erie St FL 17
Chicago, IL 60611-2987

Mailing address

259 E Erie St FL 17
Chicago, IL 60611-2987
Phone (312) 926-6000

Other practice location 1

675 N Saint Clair St # 8-150
Chicago, IL 60611-5975
Phone (312) 926-0416

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
I20170803003007 IL Practitioner - Nurse Practitioner 4486925831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Loyola University of Chicago, Stritch School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1475 E Belvidere Rd
Pavillion a Suite 214
Grayslake, IL 60030-2012
Phone (847) 926-0106

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209005363ILMDNurse Practitioner
209.005363ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2017 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

259 E Erie St
Fl 17
Chicago, IL 60611
Phone (312) 926-4566

259 E Erie St
Fl 16
Chicago, IL 60611
Phone (312) 629-2620

675 N Saint Clair St
Ste 20-150
Chicago, IL 60611
Phone (312) 695-8146

675 N Saint Clair St
#8150
Chicago, IL 60611
Phone (312) 926-0416

1475 E Belvidere Rd
Ste 214
Grayslake, IL 60030
Phone (847) 231-4445

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 4

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 1

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": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1851737548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-0516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 N Saint Clair St # 8-150",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115975",
            "country_code": "US",
            "telephone_number": "312-926-0416",
            "fax_number": "312-926-8118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARALLI",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "credential": "A.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.005363",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.