Individual provider Active NPI

Federico Ismael Herrera, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1881926913
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-130142 Issued in IL
Practice address
3059 W 26TH St
Chicago, IL 60623-4131
Phone
(773) 584-6200
NPI assigned
Jan 29, 2010
Last updated
Sep 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-130142 IL Primary

Addresses

Primary practice location

3059 W 26TH St
Chicago, IL 60623-4131

Mailing address

2001 S California Ave
Chicago, IL 60608-2486
Phone (773) 584-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address federico.herrera.1@11903.direct.athenahealth.com Direct

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
I20120809000822 IL Practitioner - Pediatric Medicine 4183870967 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-130142ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Oct 4, 2023 Accepting new patients
Riverside Health System Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

400 S Kennedy Dr
Ste 900
Bradley, IL 60915
Phone (815) 932-3132

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: federico.herrera.1@11903.direct.athenahealth.com
  • Direct secure messaging: fherrera46492@direct.riversidehealthcare.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1881926913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-584-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234131",
            "telephone_number": "773-584-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "FEDERICO",
        "middle_name": "ISMAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-130142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "federico.herrera.1@11903.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3059 W 26th St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606234131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.