Individual provider Active NPI

Theresa Zumba, RN

  • Registered Nurse
  • Evanston, IL
National Provider Identifier
1174948301
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.408744 Issued in IL
Practice address
1132 Florence Ave
Evanston, IL 60202-1143
Phone
(847) 866-6144
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.408744 IL Primary

Addresses

Primary practice location

1132 Florence Ave
Evanston, IL 60202-1143

Mailing address

5715 N Richmond St
Chicago, IL 60659-4803

Other identifiers 1

IdentifierTypeStateIssuer
041.408744OtherILSTATE OF ILLINOIS REGISTERED PROFESSIONAL NURSE

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.408744ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Housing Options for the Mentally Ill in Evanston, Inc Past Accepting new patients
Aggeus Healthcare, P.C. Past Accepting new patients

Organizations & group practices 2

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1174948301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 N RICHMOND ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 FLORENCE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021143",
            "telephone_number": "847-866-6144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUMBA",
        "first_name": "THERESA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.408744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS REGISTERED PROFESSIONAL NURSE",
            "identifier": "041.408744",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.