MARY MARLENE HOLMSTROM MSN, APRN, WHNP-BC
NPI 1063176220
Nurse Practitioner - Women's Health in Chicago, IL

Active since October 25, 2021PECOS EnrolledAccepts Medicare Assignment
111 W JACKSON BLVD STE 1700, CHICAGO, IL 60604(888) 731-8994(833) 775-1861 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 11, 2023, Mar 16, 2023 (2 updates tracked since 2023).

About Mary Marlene Holmstrom Msn, Aprn, Whnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY MARLENE HOLMSTROM MSN, APRN, WHNP-BC (NPI 1063176220) is an individual women's health provider in Chicago, Illinois, licensed in Illinois (209.026895) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1063176220
Entity TypeIndividualFemale
Primary Taxonomy363LW0102X
Provider Legal NameMARY MARLENE HOLMSTROMCredential: MSN, APRN, WHNP-BC
Location Address111 W JACKSON BLVD STE 1700Chicago, IL 60604-3597
Mailing Address111 W Jackson Blvd Ste 1700Chicago, IL 60604-3597 · (888) 731-8994 · Fax (833) 775-1861
Fax(833) 775-1861
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateOctober 25, 2021
Last NPPES UpdateAugust 18, 20252 updates tracked since enumeration
NPPES CertifiedJuly 21, 2025
NPI 1063176220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Women's HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LW0102X
License Licensed in IL · 209.026895
111 W JACKSON BLVD STE 1700, Chicago, IL 60604

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mary Marlene Holmstrom Msn, Aprn, Whnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234594581
PECOS Enrollment IDI20230420002458
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101
This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.
37 services37 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
27 services26 patients
Detection test for candida species (yeast), direct probe technique 87480
The detection test for Candida species uses a direct probe technique. This is a lab test where a sample is taken from your body, typically from the mouth or skin. The sample is then examined under a microscope to identify the presence of Candida, a type of yeast that can cause infection.
24 services22 patients
Detection test for gardnerella vaginalis (bacteria), direct probe technique 87510
This test helps find a certain type of bacteria called Gardnerella vaginalis. The direct probe technique uses a small sample from your body. This sample is then examined in a lab to see if this bacteria is present. This helps in identifying and treating any related health issues.
24 services22 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services20 patients
Detection test by nucleic acid for trichomonas vaginalis (genital parasite), direct probe technique 87660
This test helps identify a common microscopic organism that can cause discomfort. It uses a direct probe technique, which involves analyzing a small sample from your body. The test detects the organism's unique genetic material (nucleic acid), confirming its presence.
23 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Nutritionist
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Clinic/Center (Mental Health (Including Community Mental Health Center))
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Nurse Practitioner
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Psychiatry & Neurology (Psychiatry)
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Nurse Practitioner
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Nurse Practitioner
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604
Nurse Practitioner (Women's Health)
111 W JACKSON BLVD STE 1700
CHICAGO, IL 60604

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Holmstrom's NPI number?

The NPI number for Mary Holmstrom is 1063176220. It was assigned to this individual provider in the NPPES registry on October 25, 2021.

Where is Mary Holmstrom located?

Mary Holmstrom practices at 111 W Jackson Blvd Ste 1700, Chicago, IL 60604. The listed phone number is (888) 731-8994.

What is Mary Holmstrom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Women's Health, with taxonomy code 363LW0102X.

Is Mary Holmstrom enrolled in Medicare?

Yes. Mary Holmstrom is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Mary Holmstrom was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.