Individual provider Active NPI

Jillian Radecki, APRN

  • Family Nurse Practitioner
  • Oak Lawn, IL
National Provider Identifier
1952018368
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.026461 Issued in IL
Practice address
9555 S 52ND Ave
Oak Lawn, IL 60453-3054
Phone
(708) 634-0950
Fax
(708) 634-0942
NPI assigned
Nov 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 041452248 IL
Family Nurse Practitioner 363LF0000X 209.026461 IL Primary

Addresses

Primary practice location

9555 S 52ND Ave
Oak Lawn, IL 60453-3054

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

9537 S 52nd Ave
Oak Lawn, IL 60453-6045
Phone (708) 945-4257

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL Epic Health Information Exchange (HIE)
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address jradecki269815@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230213001267 IL Practitioner - Nurse Practitioner 1052783446 Reassigns benefits to 2 organizations
I20250521000046 VA Practitioner - Nurse Practitioner 1052783446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

10201 S Cicero Ave
Suite a
Oak Lawn, IL 60453-4672
Phone (708) 658-2770

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

701 E Franklin St
Suite 1051740
Richmond, VA 23219-2512
Phone (224) 607-7254

731 Hillside Ave
Glen Ellyn, IL 60137-4616
Phone (847) 570-2760

9550 W 167TH St
Orland Park, IL 60467-5561

9555 S 52ND Ave
Oak Lawn, IL 60453-3054
Phone (708) 634-0950

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041452248ILMDRegistered Nurse
209.026461ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation Single Specialty CurrentSince Dec 27, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Single Specialty Current Accepting new patients
Gatewaymd Live PLLC Single Specialty CurrentSince Nov 1, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 27, 2022 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

9555 S 52nd Ave
Oak Lawn, IL 60453
Phone (708) 422-5700

701 E Franklin St
Ste 1051740
Richmond, VA 23219
Phone (224) 607-7254

Interoperability endpoints

  • Direct secure messaging: jradecki269815@direct.myadvocateaurora.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1952018368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900",
            "fax_number": "847-390-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 S 52ND AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533054",
            "telephone_number": "708-634-0950",
            "fax_number": "708-634-0942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9537 S 52nd Ave",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604536045",
            "country_code": "US",
            "telephone_number": "708-945-4257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADECKI",
        "first_name": "JILLIAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041452248",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.026461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Epic",
            "affiliation": "N",
            "endpointDescription": "Sending and receiving information pertaining to patient care",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient care/treatment plans",
            "address_1": "9537 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604536045",
            "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": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jradecki269815@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9555 S 52nd Ave",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604533054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.