Individual provider Active NPI

Staceyann Varice

  • Family Nurse Practitioner
  • Arlington Heights, IL
National Provider Identifier
1952109134
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
00000000000 Issued in IL
Practice address
2417 S Shag Bark TRL
Arlington Heights, IL 60005-4327
Phone
(312) 841-2849
NPI assigned
Mar 4, 2025
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 00000000000 IL Primary

Addresses

Primary practice location

2417 S Shag Bark TRL
Arlington Heights, IL 60005-4327

Mailing address

2417 S Shag Bark TRL
Arlington Heights, IL 60005-4327
Phone (312) 841-2849

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250423003180 IL Practitioner - Nurse Practitioner 3375069263 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shifa Nephrology Associates LLCGroup PAC ID 6305028390, 13 clinicians

Practice addresses (Care Compare)

1540 W Chicago Ave
Chicago, IL 60642-5236
Phone (773) 423-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000000000ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HDC Care Solutions, LLC Family CurrentSince Jan 2, 2026 Accepting new patients
Value Based Long Term Care H PC CurrentSince Dec 1, 2025 Accepting new patients
Healthdrive Medical Services Southeast LLC Family CurrentSince Jan 2, 2026 Accepting new patients
Shifa Nephrology Associates LLC CurrentSince Apr 14, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Dec 1, 2025 Accepting new patients
Shifa Dialysis LLC PastSince Apr 14, 2025 Accepting new patients

Locations

1540 W Chicago Ave
Chicago, IL 60642
Phone (773) 232-2300

1544 W Chicago Ave
Chicago, IL 60642
Phone (312) 432-1707

332 S Michigan Ave
Fl 4
Chicago, IL 60604

332 S Michigan Ave
Ste 900
Chicago, IL 60604
Phone (813) 395-1073

605 N Michigan Ave
Ste 4
Chicago, IL 60611
Phone (312) 945-8109

6316 N Lincoln Ave
#200
Chicago, IL 60659
Phone (773) 423-6400

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1952109134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2417 S SHAG BARK TRL",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054327",
            "telephone_number": "312-841-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 S SHAG BARK TRL",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600054327",
            "telephone_number": "312-841-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARICE",
        "first_name": "STACEYANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "00000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.