Individual provider Active NPI

Jennifer Giarratana, NP

  • Adult Health Nurse Practitioner
  • Libertyville, IL
National Provider Identifier
1053363705
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209-005868 Issued in IL
Practice address
1800 Hollister Dr
Suite 112
Libertyville, IL 60048-5263
Phone
(847) 367-6781
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209-005868 IL Primary

Addresses

Primary practice location

1800 Hollister Dr
Suite 112
Libertyville, IL 60048-5263

Mailing address

1800 Hollister Dr
Suite 112
Libertyville, IL 60048-5263
Phone (847) 367-6781

Other identifiers 2

IdentifierTypeStateIssuer
041347841OtherILBLUE CROSS BLUE SHIELD
04282151001MedicaidIL

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-005868ILMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1053363705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR",
            "address_2": "SUITE 112",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485263",
            "telephone_number": "847-367-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HOLLISTER DR",
            "address_2": "SUITE 112",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485263",
            "telephone_number": "847-367-6781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIARRATANA",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-005868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "041347841",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04282151001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.