Individual provider Active NPI

Laura Cooper

  • Family Nurse Practitioner
  • Oakbrook Terrace, IL
National Provider Identifier
1194336107
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.021406 Issued in IL
Practice address
1S376 Summit Ave
Oakbrook Terrace, IL 60181-3985
Phone
(331) 221-1939
NPI assigned
Aug 13, 2020
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.021406 IL
Family Nurse Practitioner 363LF0000X 209.021406 IL Primary

Addresses

Primary practice location

1S376 Summit Ave
Oakbrook Terrace, IL 60181-3985

Mailing address

1S376 Summit Ave
Oakbrook Terrace, IL 60181-3985

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
I20210131000012 IL Practitioner - Nurse Practitioner 7719391945 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.021406ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicagoland Healthcare PC CurrentSince Nov 1, 2021 Accepting new patients
Humboldt Park Health PastSince Jan 14, 2021 Accepting new patients

Locations

1S376 Summit Ave
Ste 4B
Oakbrook Terrace, IL 60181
Phone (331) 221-1957

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1194336107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S376 SUMMIT AVE",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S376 SUMMIT AVE",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813985",
            "telephone_number": "331-221-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.021406",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakbrook Terrace, IL

Sources for this page

Verify at the official NPI Registry.