Individual provider Active NPI

Alana Wichmann, APN

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1124457155
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
041.400432 Issued in IL
Practice address
MC 4076 5841 S. Maryland Ave
Chicago, IL 60637
Phone
(773) 702-6140
Fax
(773) 702-6969
NPI assigned
Nov 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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 041.400432 IL Primary

Addresses

Primary practice location

MC 4076 5841 S. Maryland Ave
Chicago, IL 60637

Mailing address

5841 S. Maryland Ave
MC 4037
Chicago, IL 60637-3314
Phone (773) 702-5006

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.400432ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1124457155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S. MARYLAND AVE",
            "address_2": "MC 4037",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606373314",
            "telephone_number": "773-702-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MC 4076 5841 S. MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-6140",
            "fax_number": "773-702-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICHMANN",
        "first_name": "ALANA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-12",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041.400432",
            "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 Feb 18, 2015; 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.