Individual provider Active NPI

Elizabeth A Rochford, NP

  • Gerontology Nurse Practitioner
  • Burr Ridge, IL
National Provider Identifier
1114950409
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
277000043 Issued in IL
Practice address
6101 S County Line Rd
Burr Ridge, IL 60527-8132
Phone
(630) 686-9000
Fax
(844) 235-2578
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 277000043 IL Primary

Addresses

Primary practice location

6101 S County Line Rd
Burr Ridge, IL 60527-8132

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 2

IdentifierTypeStateIssuer
F100323989OtherILGROUP MEDICARE PTAN
041243283MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address erochford195466@dulyhealthandcare.direct-ci.com

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
I20041103000677 IL Practitioner - Nurse Practitioner 2163484957

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: erochford195466@dulyhealthandcare.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1114950409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 S COUNTY LINE RD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278132",
            "telephone_number": "630-686-9000",
            "fax_number": "844-235-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHFORD",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "277000043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "F100323989",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041243283",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erochford195466@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "6101 S County Line Rd",
            "city": "Burr Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605278132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.