Individual provider Active NPI

Caryn Naglak, FNP

  • Family Nurse Practitioner
  • Griffin, IN
National Provider Identifier
1053988436
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.016454 Issued in IL
Practice address
Midwest Express Clinic
1923 W Glen Park Ave
Griffin, IN 46319
Phone
(219) 922-2535
NPI assigned
Jun 5, 2021
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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 209.016454 IL Primary

Addresses

Primary practice location

Midwest Express Clinic
1923 W Glen Park Ave
Griffin, IN 46319

Mailing address

Midwest Express Clinic
1923 W Glen Park Ave
Griffin, IN 46319
Phone (219) 922-2535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210723002009 IN Practitioner - Nurse Practitioner 0042613325 Reassigns benefits to 3 organizations
I20220315000597 IL Practitioner - Nurse Practitioner 0042613325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.016454ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Urgent Care, LLC CurrentSince Jul 15, 2021 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 25, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 25, 2022 Accepting new patients

Locations

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

8135 Calumet Ave
Munster, IN 46321
Phone (219) 513-2000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1053988436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MIDWEST EXPRESS CLINIC",
            "address_2": "1923 W GLEN PARK AVE",
            "city": "GRIFFIN",
            "state": "IN",
            "postal_code": "46319",
            "telephone_number": "219-922-2535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MIDWEST EXPRESS CLINIC",
            "address_2": "1923 W GLEN PARK AVE",
            "city": "GRIFFIN",
            "state": "IN",
            "postal_code": "46319",
            "telephone_number": "219-922-2535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLAK",
        "first_name": "CARYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-05",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.016454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.