Elissa Marie Larkin, APN, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

209011894 Issued in IL

Practice address

2311 S Bonnie Brook LN
Waukegan, IL 60087-3721

Phone

(831) 264-3771

Fax

(888) 959-0674

NPI assigned

Jul 23, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411776000000",
    "number": "1053729020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 S BONNIE BROOK LN",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600873721",
            "telephone_number": "831-264-3771",
            "fax_number": "888-959-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 S BONNIE BROOK LN",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600873721",
            "telephone_number": "831-264-3771",
            "fax_number": "888-959-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARKIN",
        "first_name": "ELISSA",
        "middle_name": "MARIE",
        "credential": "APN, CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041421123",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WI",
            "license": "148897-32",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209011894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicole Lasak, RN
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• Laureate Terrace Operations LLC
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• Advanced Practice Midwife in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Advanced Practice Midwife in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; 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.