Individual provider Active NPI

Jeanette Conley

  • Emergency Registered Nurse
  • Chicago, IL
National Provider Identifier
1033908827
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
041557180 Issued in IL
Practice address
1620 W Harrison St
Chicago, IL 60612-3801
Phone
(312) 942-5000
NPI assigned
May 6, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 041557180 IL Primary

Addresses

Primary practice location

1620 W Harrison St
Chicago, IL 60612-3801

Mailing address

4609 S Lamon Ave
Chicago, IL 60638-2032
Phone (773) 896-6148

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041557180ILMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1033908827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 S LAMON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606382032",
            "telephone_number": "773-896-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "JEANETTE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "IL",
            "license": "041557180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.