Individual provider Active NPI

Michelle E Nellett, APN, MSN, CCRN, CCNS

  • Critical Care Medicine Clinical Nurse Specialist
  • Oak Lawn, IL
National Provider Identifier
1982938106
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X
License
209.005772 Issued in IL
Practice address
4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone
(708) 684-6359
Fax
(708) 684-1983
NPI assigned
Sep 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Clinical Nurse Specialist 364SC0200X 209.005772 IL Primary

Addresses

Primary practice location

4440 W 95TH St
Oak Lawn, IL 60453-2600

Mailing address

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-6359

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
I20210212000120 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 5890100408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-4393

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209.005772ILMDCritical Care Medicine Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Dec 11, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Dec 11, 2020 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

4440 W 95th St
Ste 6409
Oak Lawn, IL 60453
Phone (708) 684-8000

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1982938106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-6359",
            "fax_number": "708-684-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-6359",
            "fax_number": "708-684-1983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELLETT",
        "first_name": "MICHELLE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "APN, MSN, CCRN, CCNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "IL",
            "license": "209.005772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.