Individual provider Active NPI

Karen Lynn Nichols, NP

  • Family Nurse Practitioner
  • Downers Grove, IL
National Provider Identifier
1154458941
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-005936 Issued in IL
Practice address
1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone
(630) 829-1084
Fax
(630) 829-1040
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 209-005936 IL Primary

Addresses

Primary practice location

1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone (847) 360-4090

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address knichols205109@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20070614000641 IL Practitioner - Nurse Practitioner 7113025198 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Xavier UniversityGroup PAC ID 8022245083, 5 clinicians

Practice addresses (Care Compare)

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

2940 W 87TH St
Chicago, IL 60652-3832
Phone (773) 434-8787

3700 W 103Rd St
Chicago, IL 60655-3105
Phone (773) 298-3712

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-005936ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Saint Xavier University CurrentSince May 11, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 30, 2013 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Sep 30, 2013 Accepting new patients
Midway Emergency Physicians, LLC Past Accepting new patients

Locations

3 E Golf Rd
Arlington Hts, IL 60005
Phone (800) 323-0358

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

29373 Network Pl
Chicago, IL 60673

3700 W 103rd St
Chicago, IL 60655
Phone (773) 298-3712

1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038

63 W 87th St
Naperville, IL 60565
Phone (630) 778-7645

Interoperability endpoints

  • Direct secure messaging: knichols205109@direct.myadvocateaurora.org

Organizations & group practices 5

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1154458941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 BRANDING AVE STE 310",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155624",
            "telephone_number": "630-829-1084",
            "fax_number": "630-829-1040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1324 N Sheridan Rd",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600852161",
            "country_code": "US",
            "telephone_number": "847-360-4090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "KAREN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-005936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knichols205109@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.