Individual provider Active NPI

Stephanie Larson, APRN

  • Family Nurse Practitioner
  • Tinley Park, IL
National Provider Identifier
1053063529
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023947 Issued in IL
Practice address
18210 La Grange Rd
Tinley Park, IL 60487-7722
Phone
(708) 429-8700
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.023947 IL Primary

Addresses

Primary practice location

18210 La Grange Rd
Tinley Park, IL 60487-7722

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

3815 Highland Ave
Downers Grove, IL 60515-1500
Phone (630) 275-6277

Other practice location 2

3743 Highland Ave Fl 2
Downers Grove, IL 60515-1594
Phone (708) 478-7873

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address slarson267854@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220411002539 IL Practitioner - Nurse Practitioner 3971999319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1111 E 87TH St
Suite 500
Chicago, IL 60619-7038
Phone (773) 967-4840

18210 S Lagrange Rd
200 Advocate Med Group
Tinley Park, IL 60487-7725
Phone (708) 479-6636

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

3815 Highland Ave
Downers Grove, IL 60515-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.023947ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Apr 12, 2023 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Apr 12, 2023 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

3743 Highland Ave
Fl 2
Downers Grove, IL 60515
Phone (708) 478-7873

3815 Highland Ave
Downers Grove, IL 60515
Phone (630) 275-5900

18210 La Grange Rd
Tinley Park, IL 60487
Phone (708) 422-7715

Interoperability endpoints

  • Direct secure messaging: slarson267854@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1053063529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18210 LA GRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877722",
            "telephone_number": "708-429-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3815 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605151500",
            "country_code": "US",
            "telephone_number": "630-275-6277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3743 Highland Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605151594",
            "country_code": "US",
            "telephone_number": "708-478-7873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "STEPHANIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "18210 La Grange Rd",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604877722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slarson267854@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "18210 La Grange Rd",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604877722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.