Individual provider Active NPI

Elizabeth Gawne

  • Psychiatric/Mental Health Nurse Practitioner
  • Oak Lawn, IL
National Provider Identifier
1164054011
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209020685 Issued in IL
Practice address
4400 W 95TH St
Oak Lawn, IL 60453-2654
Phone
(773) 451-6221
NPI assigned
Feb 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209020685 IL Primary

Addresses

Primary practice location

4400 W 95TH St
Oak Lawn, IL 60453-2654

Mailing address

4400 W 95TH St
Oak Lawn, IL 60453-2654

Other identifiers 1

IdentifierTypeStateIssuer
209020685OtherILADVANCED PRACTICE REGISTERED NURSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address egawne264540@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
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209020685ILMDPsychiatric/Mental Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: egawne264540@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1164054011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532654",
            "telephone_number": "773-451-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWNE",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-09",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209020685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE REGISTERED NURSE",
            "identifier": "209020685",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egawne264540@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4400 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532654",
            "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": "4400 W 95th St",
            "city": "Oak Lawn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604532654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.