Individual provider Active NPI

Natalie Tamara Autenzio, APRN, CNP

  • Nurse Practitioner
  • Lake Forest, IL
National Provider Identifier
1144986571
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209029560 Issued in IL
Practice address
1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone
(847) 534-3278
Fax
(847) 535-8590
NPI assigned
Nov 10, 2021
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209029560 IL Primary
Family Nurse Practitioner 363LF0000X 209029560 IL

Addresses

Primary practice location

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone (847) 534-3278

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
I20240522002683 IL Practitioner - Nurse Practitioner 8527400548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1601
Phone (847) 735-8500

1333 W Belmont Ave
Chicago, IL 60657-5785

1630 Sherman Ave
Evanston, IL 60201-3711

350 S Waukegan
Suite 150
Deerfield, IL 60015-5239
Phone (312) 926-3107

350 S Waukegan Rd
Deerfield, IL 60015-5239
Phone (312) 926-6146

4445 W Irving Park Rd
Chicago, IL 60641-2808

525 Rockland Rd
Lake Bluff, IL 60044-1778

6155 Grand Ave
Gurnee, IL 60031-1651

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209029560ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince May 9, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 9, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1000 N Westmoreland Rd
#1
Lake Forest, IL 60045
Phone (847) 534-3278

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1144986571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-534-3278",
            "fax_number": "847-535-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-534-3278",
            "fax_number": "847-535-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUTENZIO",
        "first_name": "NATALIE",
        "middle_name": "TAMARA",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-10",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209029560",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.