Jennette Latrese Berry, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036111987 Issued in IL

Practice address

10242 S Vincennes Ave
Chicago, IL 60643-1301

Phone

(773) 238-1676

Fax

(773) 238-1641

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jennette Latrese Brister Other name

Electronic endpoints 2

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

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
• Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
• Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment Care Compare group NPD
• Advocate Health & Hospitals Corporation

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Hazel Crest, IL
  • NPI 1467560128
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Oak Lawn, IL
  • NPI 1548375082
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1558479212
  Care Compare affiliation
• Ehs Home Health Care Service Inc

  • Home Health Agency
  • Oak Brook, IL
  • NPI 1598732075
  Care Compare affiliation

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1942311972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20110 GOVERNORS HWY",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611030",
            "telephone_number": "708-747-7960",
            "fax_number": "708-503-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10242 S VINCENNES AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431301",
            "telephone_number": "773-238-1676",
            "fax_number": "773-238-1641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "JENNETTE",
        "middle_name": "LATRESE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036111987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111987",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "P00266812",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jberry206503@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4001 Vollmer Rd",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604613168",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4001 Vollmer Rd",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604613168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNETTE",
            "last_name": "BRISTER",
            "middle_name": "LATRESE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Antoinette Berry
• Caroline Berry
• Charles Henry Berry, PSY.D.
• Connor Berry, PA-C
• Jean K Berry
• Kelsey Elizabeth Berry, MD
• Krystyna Helena Berry, M.D.
• Meaghan Rose Berry, LCSW
• Melinda D Berry, LCSW
• Shira Berry, OTR/L

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.