FABIOLA NIETO (APRN) – Family Nurse Practitioner, NPI 1114502259

FABIOLA NIETO (APRN) is a healthcare provider. based in Chicago, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 209022981 (IL). The NPI Number for FABIOLA NIETO (APRN) is 1114502259

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
FABIOLA NIETO (APRN)
NPI
1114502259
Phone
(773) 584-6200
Address
4720 S CALIFORNIA AVE
Enumeration Date
10 March 2021
Last Update Date
30 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7735846140
Graduation Year
2020 (6 years ago)
PAC ID
0648651315
Group Practice PAC ID
2961453105
Professional Enrollment ID
I20220713001812
Address ID
IL606322016CH4720XAVEX400

Contacts

Secure Messaging
fabiola.nieto.1@11903.athenahealth.com
Other Endpoint
n/a
Other Endpoint
chicago
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness95
Years active:5State licenses:1Other names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for FABIOLA NIETO (APRN)

  • 4720 S CALIFORNIA AVE

    CHICAGO, IL 606322016

    Phone: (773) 584-6200

    Fax: (833) 449-4168

    Type: Mailing

  • 966 W 21ST ST

    CHICAGO, IL 606084511

    Phone: (773) 254-1400

    Type: Mailing

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: 2022-07-13

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
I20220713001812INurse 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 60632)

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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: 2961453105View full group profile
NameSpecialtyState
Family PracticeIL
-IL
Physician AssistantIN
Family PracticeIL
Certified Nurse Midwife (Cnm)IL
Family PracticeIL
Family PracticeCA
Internal MedicineIA
Family PracticeIL
Physician AssistantIL

Reviews

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Frequently asked questions

How is FABIOLA NIETO (APRN) identified in CMS data?
CMS-hosted NPPES data lists FABIOLA NIETO (APRN) with NPI 1114502259.
Is FABIOLA NIETO (APRN) listed as active for patients and plans?
The listing shows FABIOLA NIETO (APRN) as active in the NPI system.
What is FABIOLA NIETO (APRN)'s primary classification?
Family Nurse Practitioner is the headline specialty for FABIOLA NIETO (APRN) here. Clinical services aligned with this taxonomy classification.
Where should I expect FABIOLA NIETO (APRN) on a map?
Expect Chicago, Illinois as a primary anchor for FABIOLA NIETO (APRN) unless the record lists multiple sites.
Is the information about FABIOLA NIETO (APRN) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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