Individual provider Active NPI

Nancy Powers-Kirsch, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1104679703
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209.028592 Issued in IL
Practice address
561 W Diversey Pkwy Ste 215
Chicago, IL 60614-1682
Phone
(773) 906-4546
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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 209.028592 IL Primary

Addresses

Primary practice location

561 W Diversey Pkwy Ste 215
Chicago, IL 60614-1682

Mailing address

561 W Diversey Pkwy Ste 215
Chicago, IL 60614-1682
Phone (773) 906-4546

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209.028592ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Able Psychiatry LLC CurrentSince Apr 14, 2024 Accepting new patients

Locations

561 W Diversey Pkwy
Ste 215
Chicago, IL 60614
Phone (773) 906-4546

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.

NPI Registry JSON

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1104679703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 W DIVERSEY PKWY STE 215",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141682",
            "telephone_number": "773-906-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 W DIVERSEY PKWY STE 215",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141682",
            "telephone_number": "773-906-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS-KIRSCH",
        "first_name": "NANCY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.028592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.