Desiree Michelle Provax, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209018899 Issued in IL

Practice address

5145 N California Ave Ste 331
Chicago, IL 60625-3661

Phone

(847) 570-1027

Fax

(773) 989-1734

NPI assigned

Mar 25, 2019

Last updated

Nov 21, 2025By 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

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Humboldt Park HealthGroup PAC ID 8921907072, 106 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Humboldt Park Health Hospital, Chicago, IL, CCN 140206

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Humboldt Park Health

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1740417153
  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452
  Medicare reassignment NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD

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

• Humboldt Park Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1972594877
  Care Compare affiliation

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1942760962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5145 N CALIFORNIA AVE STE 331",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253661",
            "telephone_number": "847-570-1027",
            "fax_number": "773-989-1734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5237 W Windsor Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606303720",
            "country_code": "US",
            "telephone_number": "773-547-3544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROVAX",
        "first_name": "DESIREE",
        "middle_name": "MICHELLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018899",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018899",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Proverbs 3 PC (That's The Tooth)
• Proverbs 3 PC (That's The Tooth)

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; 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.