Individual provider Active NPI

Colette Mitchell

  • Registered Nurse
  • St Charles, IL
National Provider Identifier
1184578015
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041506533 Issued in IL
Practice address
2075 Foxfield Rd Ste 102
St Charles, IL 60174-1402
Phone
(847) 905-0001
NPI assigned
Feb 26, 2026
Last updated
Feb 26, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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 041506533 IL Primary

Addresses

Primary practice location

2075 Foxfield Rd Ste 102
St Charles, IL 60174-1402

Mailing address

390 E Congress Pkwy
Crystal Lake, IL 60014-6202

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
041506533ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1772064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1184578015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E CONGRESS PKWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 FOXFIELD RD STE 102",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741402",
            "telephone_number": "847-905-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COLETTE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-02-26",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041506533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; 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.