Individual provider Active NPI

Maria Teresa Queypo

  • Registered Nurse
  • Ingleside, IL
National Provider Identifier
1124568720
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.290711 Issued in IL
Practice address
604 Rollins Rd Unit 355
Ingleside, IL 60041-4401
Phone
(847) 774-2251
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.290711 IL Primary

Addresses

Primary practice location

604 Rollins Rd Unit 355
Ingleside, IL 60041-4401

Mailing address

PO Box 355
Ingleside, IL 60041-0355
Phone (847) 774-2251

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
041.290711ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1124568720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 355",
            "city": "INGLESIDE",
            "state": "IL",
            "postal_code": "600410355",
            "telephone_number": "847-774-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 ROLLINS RD UNIT 355",
            "city": "INGLESIDE",
            "state": "IL",
            "postal_code": "600414401",
            "telephone_number": "847-774-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEYPO",
        "first_name": "MARIA TERESA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.290711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ingleside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.