Susely Guevara, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.020134 Issued in IL

Practice address

3600 W Fullerton Ave
Chicago, IL 60647-2319

Phone

(773) 782-2800

NPI assigned

Dec 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Infant Welfare Society of ChicagoGroup PAC ID 6800137407, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susely.guevara@iws.eclinicaldirectplus.com

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.

• Infant Welfare Society of Chicago

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1497872543

  IL

  Medicare reassignment Care Compare group NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669493466

  IL

  Medicare reassignment
• Infant Welfare Society of Chicago

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1447071253
  NPD (past)

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601337600000",
    "number": "1962049452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4149 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234314",
            "telephone_number": "773-410-7366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4149 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606234314",
            "country_code": "US",
            "telephone_number": "773-542-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "SUSELY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "susely.guevara.1@17986.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3600 W Fullerton Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606472319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Francisco Guevara
• Javier Guevara Jr., M.D.
• Maria Teresa Guevara, LPC, NCC
• Maryrose Guevara
• Nicolas David Guevara, MD
• Erika Guevarra, RN
• Felisa Mae David Guevarra, APN
• Lindsay Gugerty, DO
• Vijeeth Guggilla
• Kristen Taylor Guglielmi

• All providers in Chicago, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.