Individual provider Active NPI

Jessica Myles, FNP-BC

  • Family Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1982362984
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024726 Issued in IL
Practice address
9735 Skokie Blvd
Skokie, IL 60077-1383
Phone
(847) 380-8969
NPI assigned
Dec 7, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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 209024726 IL Primary

Addresses

Primary practice location

9735 Skokie Blvd
Skokie, IL 60077-1383

Mailing address

9735 Skokie Blvd
Skokie, IL 60077-1383
Phone (847) 380-8969

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
I20220211001261 IL Practitioner - Nurse Practitioner 9335532456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209024726ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Jan 24, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 24, 2022 Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

9735 Skokie Blvd
Skokie, IL 60077
Phone (847) 380-8969

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1982362984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771383",
            "telephone_number": "847-380-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771383",
            "telephone_number": "847-380-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "JESSICA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.