Active NPI
Peter Costello
- Psychiatric/Mental Health Nurse Practitioner
- Brookfield, IL
National Provider Identifier
1952288946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209.032933
- Practice address
- 4235 Elm Ave
Brookfield, IL 60513-1903 - Phone
- (708) 271-0158
- NPI assigned
- Aug 20, 2025
- Last updated
- Aug 20, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209.032933 | IL | Primary |
Addresses
Primary practice location
4235 Elm Ave
Brookfield, IL 60513-1903
Mailing address
4235 Elm Ave
Brookfield, IL 60513-1903
Phone (708) 271-0158
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1790 Nations Dr
Suite 213
Gurnee, IL 60031-9176
Phone (888) 428-7890
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.032933 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
Organizations & group practices 1
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": "1755648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755648000000",
"number": "1952288946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4235 ELM AVE",
"city": "BROOKFIELD",
"state": "IL",
"postal_code": "605131903",
"telephone_number": "708-271-0158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4235 ELM AVE",
"city": "BROOKFIELD",
"state": "IL",
"postal_code": "605131903",
"telephone_number": "708-271-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "PETER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-20",
"last_updated": "2025-08-20",
"certification_date": "2025-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209.032933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.