Individual provider Active NPI

Kristin Rogers

  • Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1093474942
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.026476 Issued in IL
Practice address
3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone
(708) 346-5562
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.026476 IL Primary

Addresses

Primary practice location

3545 W 95TH St
Evergreen Park, IL 60805-2135

Mailing address

3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone (708) 346-5562

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
I20230222001918 IL Practitioner - Nurse Practitioner 0749653780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Cardiology and Electrophysiololgy LLCGroup PAC ID 4880779727, 21 clinicians

Practice addresses (Care Compare)

3545 W 95TH St
Evergreen Park, IL 60805-2135
Phone (708) 346-5562

Hospital & facility affiliations

  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.026476ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Cardiology & Electrophysiololgy LLC CurrentSince Mar 1, 2023 Accepting new patients

Locations

3545 W 95th St
Evergreen Pk, IL 60805
Phone (708) 435-9036

Interoperability endpoints

  • Direct secure messaging: krogers315921@direct.myadvocateaurora.org

Organizations & group practices 1

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": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1093474942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052135",
            "telephone_number": "708-346-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052135",
            "telephone_number": "708-346-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.026476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.