Tracie E Clisby

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277.002085 Issued in IL

Practice address

5841 S Maryland Ave
Chicago, IL 60637-1443

Phone

(888) 824-0200

NPI assigned

Feb 24, 2012

Last updated

Mar 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tclisby145193@direct.rush.rush-health.com
• Direct secure messaging: tclisbyapn15520@uchospital.direct-ci.com

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.

• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786
  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Cermak Medical Group LLC

  • Family Medicine Physician
  • Cicero, IL
  • NPI 1518498393
  Medicare reassignment NPD
• Minuteclinic Diagnostic of Illinois PLLC

  • Family Nurse Practitioner
  • Mokena, IL
  • NPI 1356485809
  Medicare reassignment NPD
• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• Life Solutions Health

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1396678637
  NPD Authorized official
• Advocate Health & Hospitals Corporation

  dba Advocate Christ Medical Group

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

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Board of Trustees of the University of Illinois

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1891913992
  NPD
• Mea Chicago PC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1891216354
  NPD

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

• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1942574769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5367",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606805367",
            "telephone_number": "773-340-1307",
            "fax_number": "773-232-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371443",
            "telephone_number": "888-824-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 W Harrison St Ste 5367",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606993916",
            "country_code": "US",
            "telephone_number": "773-340-1307",
            "fax_number": "773-232-8195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLISBY",
        "first_name": "TRACIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277002085",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.002085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tclisbyapn15520@uchospital.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "University of Chicago Physicians Group",
            "address_1": "5841 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clinics for Wellness and Neuropathy, LLC
• Durrell D Clinkscales
• Catherine Clinton, M.D.
• Samantha Clinton, RN
• Timothy A Clinton, DNP, AGACNP-BC, APRN
• Bradley Clodfelter, O.D.
• Luke Christopher Clohisy, MSW
• Robin Rogers Cloman
• Tiffany Clomax
• Kelly Clor, DPT

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, 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 Mar 11, 2024; 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.