Individual provider Active NPI

Cathlin B Poronsky, R.N., A.P.N.

  • Nurse Practitioner
  • Palos Heights, IL
National Provider Identifier
1174537526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Practice address
6400 W College Dr
Suite 200
Palos Heights, IL 60463-1785
Phone
(708) 389-5555
Fax
(708) 389-8814
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X IL Primary

Addresses

Primary practice location

6400 W College Dr
Suite 200
Palos Heights, IL 60463-1785

Mailing address

4808 Central Ave
Western Springs, IL 60558-1703
Phone (708) 246-6051

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041-164845ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174537526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 CENTRAL AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581703",
            "telephone_number": "708-246-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W COLLEGE DR",
            "address_2": "SUITE 200",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631785",
            "telephone_number": "708-389-5555",
            "fax_number": "708-389-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORONSKY",
        "first_name": "CATHLIN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "R.N., A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.