Virginia Bahena, FNP-BC, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023019943 Issued in IL

Practice address

5747 W Fullerton Ave
Chicago, IL 60639-2353

Phone

(773) 413-7264

Fax

(773) 413-7013

NPI assigned

Jan 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vida Health Wellness, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1720851413
  Medicare reassignment NPD Authorized official
• Elemental Care - Health & Wellness Center, LLC

  • Family Nurse Practitioner
  • Crest Hill, IL
  • NPI 1568908739
  Medicare reassignment NPD

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

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1992411987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5747 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392353",
            "telephone_number": "773-413-7264",
            "fax_number": "773-413-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5747 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392353",
            "telephone_number": "773-413-7264",
            "fax_number": "773-413-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHENA",
        "first_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025213",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "2023019943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roya Baharestani
• Andrew Daniel Bahena, LCSW, MSW, PEL: SSW
• Guadalupe Bahena
• Liliana Pinto Bahena, DNP, APRN, FNP-BC
• Vicenta Bahena, L.M.T
• Yesenia Bahena, M.D.
• Akanksha Baheti
• Amritpal Singh Bahga, MD
• Thomas T Bahk, MD
• Minni Bahl

• Psychiatric/Mental Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.