Individual provider Active NPI

Jennifer Atadero, M.D.

  • Family Medicine Physician
  • Algonquin, IL
National Provider Identifier
1881692275
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
2220 Huntington Dr N
Algonquin, IL 60102-4419
Phone
(847) 854-0050
Fax
(847) 854-0055
NPI assigned
Jul 11, 2005
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

2220 Huntington Dr N
Algonquin, IL 60102-4419

Mailing address

2220 Huntington Dr N
Algonquin, IL 60102-4419
Phone (847) 854-0050

Other identifiers 2

IdentifierTypeStateIssuer
0360997738MedicaidIL
05632094OtherILBLUE CROSS BLUE SHIELD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040515000253 IL Practitioner - Family Practice 4486644093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Algonquin Family Healthcare PCGroup PAC ID 5698765295, 2 clinicians

Practice addresses (Care Compare)

2220 Huntington Dr N
Algonquin, IL 60102-4419
Phone (847) 854-0050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036097738ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Algonquin Family Healthcare PC Family Medicine CurrentSince May 1, 2004 Accepting new patients
Sherman Hospital Past Accepting new patients

Locations

2220 Huntington Dr N
Algonquin, IL 60102
Phone (847) 854-0050

600 S Randall Rd
Ste 210C
Algonquin, IL 60102

1950 Larkin Ave
Elgin, IL 60123
Phone (847) 742-5200

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

Interoperability endpoints

  • Direct secure messaging: jatadero288547@direct.myadvocateaurora.org

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

Hospital & facility affiliations 6

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1881692275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 HUNTINGTON DR N",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024419",
            "telephone_number": "847-854-0050",
            "fax_number": "847-854-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 HUNTINGTON DR N",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601024419",
            "telephone_number": "847-854-0050",
            "fax_number": "847-854-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATADERO",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360997738",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05632094",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.