Individual provider Active NPI

Robin Marie Ivy, NP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1124939954
Registry record updated Sep 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.035672 Issued in IL
Practice address
1950 W Polk St
Chicago, IL 60612-3723
Phone
(312) 864-6912
NPI assigned
Sep 12, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.390063 IL
Family Nurse Practitioner 363LF0000X 209.035672 IL Primary

Addresses

Primary practice location

1950 W Polk St
Chicago, IL 60612-3723

Mailing address

11019 S Green St
Chicago, IL 60643-3809
Phone (773) 330-1110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1124939954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11019 S GREEN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433809",
            "telephone_number": "773-330-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 W POLK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123723",
            "telephone_number": "312-864-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "ROBIN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-12",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.390063",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.035672",
            "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 Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.