Individual provider Active NPI

Devin Renee Haub, FNP-C

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1952835910
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015854 Issued in IL
Practice address
125 S Wacker Dr Ste 300
Chicago, IL 60606-4421
Phone
(617) 505-1520
Fax
(617) 928-8401
NPI assigned
Apr 17, 2017
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 209015854 IL Primary

Addresses

Primary practice location

125 S Wacker Dr Ste 300
Chicago, IL 60606-4421

Mailing address

109 State St Ste 5
Boston, MA 02109-2906
Phone (617) 505-1520

Other names 1

  • Devin Renee Rudolph Former name

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
I20211008000682 IL Practitioner - Nurse Practitioner 7012276967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1307 E McCord
Centralia, IL 62801-3610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Surgical Technology, LLC CurrentSince Aug 1, 2022 Accepting new patients
Form Health Associates Ma, P.C. CurrentSince Dec 8, 2025 Accepting new patients
Advanced Surgical Technology, LLC CurrentSince Aug 1, 2022 Accepting new patients
Form Health Associates, P.C. Past Accepting new patients
Healthy Life Physicians Group, P.C. Past Accepting new patients

Locations

125 S Wacker Dr
Ste 300
Chicago, IL 60606
Phone (254) 760-0283

3001 Williamson County Pkwy
Ste C
Marion, IL 62959
Phone (618) 969-8886

109 State St
Ste 5
Boston, MA 02109

Interoperability endpoints

  • Direct secure messaging: dhaub@yourcarecommunity.org
  • Direct secure messaging: advancedsurgicaltechnologyllc.devinhaub@131021.advancedmd-direct.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1952835910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STATE ST STE 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092906",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S WACKER DR STE 300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606064421",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUB",
        "first_name": "DEVIN",
        "middle_name": "RENEE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVIN",
            "last_name": "RUDOLPH",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.