Individual provider Active NPI

Elizabeth Casabal, APRN, FNP-BC

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1861912636
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209015992 Issued in IL
Practice address
2222 W Division St Ste 205
Chicago, IL 60622-3094
Phone
(708) 955-5561
NPI assigned
Jun 22, 2017
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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 209015992 IL Primary

Addresses

Primary practice location

2222 W Division St Ste 205
Chicago, IL 60622-3094

Mailing address

7229 Flagg Creek Dr
Indian Head Park, IL 60525-5306

Other practice location 1

7229 Flagg Creek Dr
Indian Head Park, IL 60525-5306
Phone (708) 955-5561

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
I20210128002843 IL Practitioner - Nurse Practitioner 4082028246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esperanza Health CentersGroup PAC ID 2961453105, 53 clinicians

Practice addresses (Care Compare)

4700 S California Ave
Chicago, IL 60632-2016
Phone (773) 584-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015992ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Esperanza Health Centers Current Accepting new patients
Esperanza Health Centers CurrentSince Nov 1, 2021 Accepting new patients
Esperanza Health Centers CurrentSince Nov 1, 2021 Accepting new patients
Esperanza Health Centers Past Accepting new patients
Esperanza Health Centers Past Accepting new patients
Esperanza Health Centers Past Accepting new patients

Locations

2001 S California Ave
Chicago, IL 60608
Phone (773) 484-1201

2001 S California Ave
Ste 100
Chicago, IL 60608
Phone (773) 640-5785

4058 W 63rd St
Chicago, IL 60629
Phone (773) 432-4033

4700 S California Ave
Chicago, IL 60632
Phone (708) 713-0078

Interoperability endpoints

  • Direct secure messaging: elizabeth.casabal.1@11903.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/11903/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1861912636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7229 FLAGG CREEK DR",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605255306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W DIVISION ST STE 205",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606223094",
            "telephone_number": "708-955-5561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7229 Flagg Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Indian Head Park",
            "state": "IL",
            "postal_code": "605255306",
            "country_code": "US",
            "telephone_number": "708-955-5561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASABAL",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.