JUANATA MUA – Family Nurse Practitioner, NPI 1053093781

JUANATA MUA is a healthcare provider. based in Chicago, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209.027546 (IL). The NPI Number for JUANATA MUA is 1053093781

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
JUANATA MUA
NPI
1053093781
Phone
(773) 449-5875
Address
9119 S EXCHANGE AVE
Enumeration Date
2 August 2023
Last Update Date
26 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7737685000
Graduation Year
2022 (4 years ago)
PAC ID
5294260782
Group Practice PAC ID
6608765417
Professional Enrollment ID
I20241120003327
Address ID
IL606285740CH570XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for JUANATA MUA

  • 9119 S EXCHANGE AVE

    CHICAGO, IL 606174225

    Phone: (773) 449-5875

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241120003327INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60617)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6608765417View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIN
Family PracticeTX
Nurse PractitionerIL
Internal Medicine, Geriatric MedicineIL
-IL
Clinical PsychologistIL

Reviews

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Frequently asked questions

Does JUANATA MUA share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JUANATA MUA uses 1053093781.
Does CMS list JUANATA MUA as active?
Yes — JUANATA MUA is active in the NPI listing used on this page.
What healthcare role does JUANATA MUA hold?
Scheduling teams often label JUANATA MUA under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does JUANATA MUA list a practice location?
Patients near Chicago, Illinois may find JUANATA MUA in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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