Individual provider Active NPI

Katelyn Breitenstein, FNP

  • Family Nurse Practitioner
  • Round Lake Beach, IL
National Provider Identifier
1114720141
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030992 Issued in IL
Practice address
224 W Clarendon Dr
Round Lake Beach, IL 60073-1896
Phone
(847) 377-8800
NPI assigned
Mar 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 209030992 IL Primary

Addresses

Primary practice location

224 W Clarendon Dr
Round Lake Beach, IL 60073-1896

Mailing address

16 Indian TRL
Lake in the Hills, IL 60156-1318
Phone (847) 641-0288

Other names 1

  • Katelyn Stinson Former name

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
I20251107004390 IL Practitioner - Nurse Practitioner 1557851441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LakeGroup PAC ID 7214838861, 42 clinicians

Practice addresses (Care Compare)

224 W Clarendon Dr
Round Lake Beach, IL 60073-1896
Phone (847) 377-8800

Hospital & facility affiliations

  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209030992ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake Current Accepting new patients
County of Lake CurrentSince Jul 11, 2025 Accepting new patients
County of Lake CurrentSince Jul 11, 2025 Accepting new patients

Locations

224 W Clarendon Dr
Round Lake Beach, IL 60073
Phone (847) 377-8800

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: katie.breitenstein.p1@direct.lakecountyil.nextgenshare.com

Organizations & group practices 11

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 3

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": "1743033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1114720141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 INDIAN TRL",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601561318",
            "telephone_number": "847-641-0288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W CLARENDON DR",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600731896",
            "telephone_number": "847-377-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITENSTEIN",
        "first_name": "KATELYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-27",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "STINSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Round Lake Beach, IL

Sources for this page

Verify at the official NPI Registry.