Individual provider Active NPI

Mary Patricia Becker, RN, MSN, FNP-BC

  • Nurse Practitioner
  • Danville, IL
National Provider Identifier
1982980124
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.008983 Issued in IL
Practice address
812 N Logan Ave
Danville, IL 61832-3752
Phone
(217) 443-5221
NPI assigned
Nov 2, 2011
Last updated
Aug 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.008983 IL Primary

Addresses

Primary practice location

812 N Logan Ave
Danville, IL 61832-3752

Mailing address

533 W North Ave
Suite 102
Elmhurst, IL 60126-2135
Phone (630) 941-4359

Other practice location 1

100 Gore Rd
Morris, IL 60450-9466
Phone (815) 364-8919

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
I20120423000287 IL Practitioner - Nurse Practitioner 2961663711 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Practice addresses (Care Compare)

17960 Halsted St
Homewood, IL 60430-2014
Phone (708) 922-0911

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.008983ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital Current Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince May 1, 2020 Accepting new patients
Morris Hospital Current Accepting new patients
Morris Hospital CurrentSince Aug 3, 2023 Accepting new patients
Morris Hospital Current Accepting new patients
Kennekuk Emergency Physicians LLC PastSince Oct 1, 2023 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

1511 Greenwood Rd
Glenview, IL 60026
Phone (847) 729-9090

100 Gore Rd
Morris, IL 60450
Phone (815) 364-8919

150 W High St
Morris, IL 60450
Phone (815) 942-2129

6631 N Milwaukee Ave
Niles, IL 60714
Phone 84723561303

Interoperability endpoints

  • Direct secure messaging: mary.becker.1@14940.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1320192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1982980124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W NORTH AVE",
            "address_2": "SUITE 102",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262135",
            "telephone_number": "630-941-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323752",
            "telephone_number": "217-443-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Gore Rd",
            "address_purpose": "LOCATION",
            "city": "Morris",
            "state": "IL",
            "postal_code": "604509466",
            "country_code": "US",
            "telephone_number": "815-364-8919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECKER",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-02",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.008983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.