Individual provider Active NPI

Kathryn Ruth, FNP

  • Family Nurse Practitioner
  • Mokena, IL
National Provider Identifier
1164257010
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209030414 Issued in IL
Practice address
11200 Lincoln Hwy
Mokena, IL 60448-8208
Phone
(866) 389-2727
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 209030414 IL Primary

Addresses

Primary practice location

11200 Lincoln Hwy
Mokena, IL 60448-8208

Mailing address

11200 Lincoln Hwy
Mokena, IL 60448-8208
Phone (866) 389-2727

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
I20241127002370 IL Practitioner - Nurse Practitioner 3476088444 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-8372

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209030414ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince Nov 13, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Apr 12, 2025 Accepting new patients
Minuteclinic Primary Care Illinois PLLC Family CurrentSince Apr 15, 2025 Accepting new patients
Loyola University Medical Center CurrentSince Apr 12, 2025 Accepting new patients
Minuteclinic Video Virtual Care North, LLC Family CurrentSince Nov 13, 2024 Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

936 Willow Rd
Northbrook, IL 60062
Phone (847) 239-8447

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

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.

Hospital & facility affiliations 2

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": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1164257010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 LINCOLN HWY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488208",
            "telephone_number": "866-389-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LINCOLN HWY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488208",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTH",
        "first_name": "KATHRYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209030414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.