Eva Grimaldo, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277000274 Issued in IL

Practice address

1764 Napa Suwe LN
Wauconda, IL 60084-1409

Phone

(847) 262-3848

NPI assigned

Sep 20, 2014

Last updated

Nov 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1922400084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 NAPA SUWE LN",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600841409",
            "telephone_number": "847-219-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 NAPA SUWE LN",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600841409",
            "telephone_number": "847-262-3848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1539 Clavey Rd",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "IL",
            "postal_code": "600354414",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMALDO",
        "first_name": "EVA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-20",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000274",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041296646",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Jenell Gardner, APN
• Shaily Gaudani, PA-C
• Rachael A Gere, M.S. CCC-SLP
• Sujatha R Gogula, PA
• Carlos Gonzalez
• Nancy Grobarek, LCSW
• Ashley Elizabeth Grooms
• Tracy Hansen, RN
• Larissa Vera Hanza, RPH
• Madison E Hausherr

• Family Nurse Practitioner in Wauconda, IL
• Providers in Wauconda, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.