Individual provider Active NPI

Nicole Lynn Burnham, R.N.

  • Registered Nurse
  • Chicago, IL
National Provider Identifier
1144500729
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.394818 Issued in IL
Practice address
4538 N Artesian Ave
#2
Chicago, IL 60625-3004
Phone
(773) 550-9388
NPI assigned
Aug 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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 041.394818 IL Primary

Addresses

Primary practice location

4538 N Artesian Ave
#2
Chicago, IL 60625-3004

Mailing address

4538 N Artesian Ave
#2
Chicago, IL 60625-3004
Phone (773) 550-9388

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.394818ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1144500729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4538 N ARTESIAN AVE",
            "address_2": "#2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253004",
            "telephone_number": "773-550-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4538 N ARTESIAN AVE",
            "address_2": "#2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253004",
            "telephone_number": "773-550-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.394818",
            "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 Aug 26, 2011; 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.