Individual provider Active NPI

Emily Diane Johnson, APRN, CNP

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1861181083
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209028064 Issued in IL
Practice address
201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Phone
(312) 926-7140
Fax
(312) 707-2467
NPI assigned
May 3, 2023
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209028064 IL Primary
Acute Care Nurse Practitioner 363LA2100X 209.028064 IL
Registered Nurse 163W00000X 041430416 IL

Addresses

Primary practice location

201 E Huron St Ste 11-140
Chicago, IL 60611-2968

Mailing address

201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Phone (312) 926-7140

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
I20231013003032 IL Practitioner - Nurse Practitioner 6103271994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041430416ILMDRegistered Nurse
209.028064ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Oct 2, 2023 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 2, 2023 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

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

Dept 5777
Carol Stream, IL 60122

201 E Huron St
Ste 11-140
Chicago, IL 60611
Phone (312) 664-3278

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1861181083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E HURON ST STE 11-140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112968",
            "telephone_number": "312-926-7140",
            "fax_number": "312-707-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HURON ST STE 11-140",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112968",
            "telephone_number": "312-926-7140",
            "fax_number": "312-707-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "DIANE",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209028064",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.028064",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041430416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.