Individual provider Active NPI

Markizh Johnson

  • Adult Health Clinical Nurse Specialist
  • Chicago, IL
National Provider Identifier
1164898631
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
209008754 Issued in IL
Practice address
3601 S Wells St
303
Chicago, IL 60609-1867
Phone
(773) 544-0504
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 041340029 IL
Adult Health Clinical Nurse Specialist 364SA2200X 209008754 IL Primary

Addresses

Primary practice location

3601 S Wells St
303
Chicago, IL 60609-1867

Mailing address

3601 S Wells St
303
Chicago, IL 60609-1867
Phone (773) 544-0504

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

State licenses

LicenseStateTypeSpecialty
041340029ILMDGeneral Practice Registered Nurse
209008754ILMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1164898631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 S WELLS ST",
            "address_2": "303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091867",
            "telephone_number": "773-544-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 S WELLS ST",
            "address_2": "303",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091867",
            "telephone_number": "773-544-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARKIZH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041340029",
            "primary": false
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209008754",
            "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 19, 2015; 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.