Susan A Mack, APRN-FPA

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277000186 Issued in IL

Practice address

514 Teela LN
Des Plaines, IL 60016-1230

Phone

(847) 692-6000

Fax

(847) 692-6112

NPI assigned

Aug 16, 2005

Last updated

Dec 7, 2021By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL, Nurse Practitioner

  Medicare reassignment NPD
• Mobile Woundcare Consultants

  • Nurse Practitioner
  • Des Plaines, IL
  • NPI 1295727469
  NPD (past) Authorized official
• Wound & Rehab Home Health Care, Inc

  • Home Health Agency
  • Park Ridge, IL
  • NPI 1184954190
  Authorized official Same address or phone
• Woundcare at Home

  • Family Nurse Practitioner
  • Des Plaines, IL
  • NPI 1902844400
  NPD (past) Authorized official
• Woundcare on Wheels Inc

  • Wound Care Registered Nurse
  • Naperville, IL
  • NPI 1043342223
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1003808270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 TEELA LN",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161230",
            "telephone_number": "847-692-6000",
            "fax_number": "847-692-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 TEELA LN",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161230",
            "telephone_number": "847-692-6000",
            "fax_number": "847-692-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "APRN-FPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209002933",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mac RX, LLC
• Mariia Machalina
• Sayaka Machizawa, PSYD
• Dominika Malgorzata Machlowska
• Allison Mack, PA
• Klaudia Macko
• Lauren Anne Macnab
• Elvina Marshal Macwan
• Jini Xavier Madathil, NP
• Jason H Madia, PHARMD

• Family Nurse Practitioner in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.