Active NPI
Sandra Jaeschke, CNP
- Nurse Practitioner
- Crystal Lake, IL
National Provider Identifier
1003815770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209003766
- Practice address
- 360 Station Dr
Crystal Lake, IL 60014-7978 - Phone
- (815) 338-6600
- Fax
- (815) 455-8044
- NPI assigned
- Jul 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209003766 | IL | Primary |
Addresses
Primary practice location
360 Station Dr
Crystal Lake, IL 60014-7978
Mailing address
360 Station Dr
Crystal Lake, IL 60014
Phone (815) 338-6600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Elgin Emergency Specialists LTD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Elgin, IL
- NPI 1134152366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502150400000",
"number": "1003815770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 STATION DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "60014",
"telephone_number": "815-338-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 STATION DR",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147978",
"telephone_number": "815-338-6600",
"fax_number": "815-455-8044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAESCHKE",
"first_name": "SANDRA",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-15",
"last_updated": "2017-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209003766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.