MPAC PHC OF IL PC
NPI 1396402129
Nurse Practitioner in Chicago, IL

Q: What is Mpac Phc Of Il PC's NPI number?

The NPI number for Mpac Phc Of Il PC is 1396402129. It was assigned to this organization in the NPPES registry on November 29, 2021.

Q: What is Mpac Phc Of Il PC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mpac Phc Of Il PC was last updated on December 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since November 29, 2021

200 N LA SALLE ST STE 1550, CHICAGO, IL 60601(888) 705-8722 Get Directions Write a Review

NPPES record last updated: December 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 10, 2021, Nov 29, 2021 (2 updates tracked since 2021).

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About Mpac Phc Of Il Pc NPPES

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

MPAC PHC OF IL PC (NPI 1396402129) is a healthcare organization registered as a nurse practitioner in Chicago, Illinois and active in the NPI registry since November 2021. The organization lists Timothy Martinez, Ceo, as its authorized official.

NPPES Registry Identity

NPI1396402129

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameMPAC PHC OF IL PC

Location Address200 N LA SALLE ST STE 1550Chicago, IL 60601-1034

Mailing AddressPo Box 5031 Pmb 17336Evanston, IL 60204-5031 · (888) 705-8722 · Fax (888) 705-8722

Phone(888) 705-8722

Organization SubpartNo

Authorized OfficialTimothy MartinezCeo · (888) 660-4425

Enumeration DateNovember 29, 2021

Last NPPES UpdateDecember 10, 20212 updates tracked since enumeration

NPPES CertifiedDecember 10, 2021

✔ NPI 1396402129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

200 N LA SALLE ST STE 1550, Chicago, IL 60601

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

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

BRINDERJIT BENIPAL APN

Nurse Practitioner (Family)