Individual provider Active NPI

Katherine Niemyski

  • Family Nurse Practitioner
  • Norridge, IL
National Provider Identifier
1124982038
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.032377 Issued in IL
Practice address
4900 N Cumberland Ave
Norridge, IL 60706-2901
Phone
(708) 456-1600
NPI assigned
Dec 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 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 209.032377 IL Primary

Addresses

Primary practice location

4900 N Cumberland Ave
Norridge, IL 60706-2901

Mailing address

4900 N Cumberland Ave
Norridge, IL 60706-2901

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
I20260326001088 IL Practitioner - Nurse Practitioner 8325523566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14 Bristol Lane
Ellicohville, NY 14731-0500

PO Box
Suite 500
Ellicottville, NY 14731-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.032377ILMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1765756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1124982038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 N CUMBERLAND AVE",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "607062901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 N CUMBERLAND AVE",
            "city": "NORRIDGE",
            "state": "IL",
            "postal_code": "607062901",
            "telephone_number": "708-456-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMYSKI",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-15",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.032377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norridge, IL

Sources for this page

Verify at the official NPI Registry.