Mary Patricia Ko, APN NURSE PRACTITION

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

AP60270270 Issued in WA

Practice address

3800 N. California Ave
Chicago, IL 60618

Phone

(773) 478-4222

Fax

(773) 478-7867

NPI assigned

Apr 11, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Mary Patricia Braunschweig Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1013273374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 BURR RIDGE PKWY",
            "address_2": "SUITE 200",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "60527",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N. CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60618",
            "telephone_number": "773-478-4222",
            "fax_number": "773-478-7867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "APN NURSE PRACTITION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP60270270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BRAUNSCHWEIG",
            "middle_name": "PATRICIA",
            "prefix": "MS.",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jae Ko, DDS
• Jason Hyunsuk Ko, M.D.
• Jennifer Ko
• Jocelyn S Rancap Ko, APRN
• Kichul Ko
• Michael Y Ko, MD
• Samuel Y Ko
• Jasmine Koback
• Sharon Kobak, D.O.
• Alison Marie Kobel, M.S. CCC-SLP

• Acute Care Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Acute Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.