NPIMap

Individual provider Active NPI

Carolyn A. Dickens

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1962516773
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277.002899 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 041312669 IL
Acute Care Nurse Practitioner 363LA2100X 277.002899 IL
Nurse Practitioner 363L00000X 277.002899 IL Primary

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

809 S Marshfield Ave
9TH Floor (M/C 732)
Chicago, IL 60612-4305
Phone (312) 996-7699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090529000510 IL Practitioner - Nurse Practitioner 9638228232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Johns Hopkins University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of Illinois 1,134 clinicians

Practice addresses (Care Compare)

1801 W Taylor St
Chicago, IL 60612-4795

1855 W Taylor St
Chicago, IL 60612-7242
Phone (312) 996-6590

Hospital & facility affiliations

  • University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041312669ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Mar 1, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients

Locations

722 W Maxwell St
#235
Chicago, IL 60607
Phone (312) 433-4114

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

7732 Solutions Ctr
Chicago, IL 60677

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

809 S Marshfield Ave
Fl 9
Chicago, IL 60612
Phone (312) 996-7699

1713 S Ashland Ave
Chicago, IL 60608
Phone (312) 421-5382

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

Interoperability endpoints

  • Direct secure messaging: cdickens16988@uihealth.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Erie Johnson School Based Health CenterChicago, IL, CCN 141035 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Family Health Center, IncChicago, IL, CCN 141086 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Helping Hands Family Health CenterChicago, IL, CCN 141009 Federally qualified health center Corporate Officer Nov 1, 2017
Humboldt Park Family Health CenterChicago, IL, CCN 141835 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Family Health Center, IncChicago, IL, CCN 141829 Federally qualified health center Corporate Director Nov 1, 2017
Erie Clemente Wildcats Health CenterChicago, IL, CCN 141098 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Lake View School Based Health CenterChicago, IL, CCN 141145 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Amundsen School Based Health CenterChicago, IL, CCN 141146 Federally qualified health center Corporate Director Nov 1, 2007
Erie Division Street Health CenterChicago, IL, CCN 141166 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Evanston Skokie Health CenterEvanston, IL, CCN 141174 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Foster Avenue Health CenterChicago, IL, CCN 141199 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Waukegan Health CenterWaukegan, IL, CCN 781818 Federally qualified health center Corporate Officer Nov 1, 2017
Erie Family Health Center, IncChicago, IL, CCN C41055 Federally qualified health center Corporate Director Nov 1, 2017

Owned or controlled facilities with NPI records 13

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 13

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 1

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1962516773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 S MARSHFIELD AVE",
            "address_2": "9TH FLOOR (M/C 732)",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124305",
            "telephone_number": "312-996-7699",
            "fax_number": "312-996-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "CAROLYN",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041312669",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "277.002899",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277.002899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.