Individual provider Active NPI

Karen S Dicken, APN/CNS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Hoffman Estates, IL
National Provider Identifier
1063420230
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
209-001072 Issued in IL
Practice address
1786 Moon Lake Blvd
#104
Hoffman Estates, IL 60169-5029
Phone
(847) 755-8090
Fax
(847) 843-7393
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209-001072 IL
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 209-001072 IL Primary

Addresses

Primary practice location

1786 Moon Lake Blvd
#104
Hoffman Estates, IL 60169-5029

Mailing address

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090

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
I20040907001248 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 8628044096

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-1016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
209-001072ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Behavioral Health Hospital Past Accepting new patients
Lifecore SC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/aa9a3bec-4c8c-4fc5-b283-495def30e623/
  • FHIR API: https://api.platform.athenahealth.com/380/brand/6/csg/181/fhir/r4
  • FHIR API: https://epicmobile.presencehealth.org/fhirPRD/api/FHIR/R4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1063420230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "SUITE 104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "address_2": "#104",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090",
            "fax_number": "847-843-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEN",
        "first_name": "KAREN",
        "middle_name": "S",
        "credential": "APN/CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209-001072",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209-001072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.