Individual provider Active NPI

Aneta Trybula, RN, BSN, MSN, AGACNP

  • Acute Care Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1205452489
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209.021360 Issued in IL
Practice address
10604 W 154TH PL
Orland Park, IL 60462-6025
Phone
(708) 515-2222
NPI assigned
Jun 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.021360 IL Primary

Addresses

Primary practice location

10604 W 154TH PL
Orland Park, IL 60462-6025

Mailing address

10604 W 154TH PL
Orland Park, IL 60462-6025
Phone (708) 515-2222

Other names 1

  • Aneta Mucha Former name

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
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
209.021360ILMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1205452489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10604 W 154TH PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626025",
            "telephone_number": "708-515-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10604 W 154TH PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604626025",
            "telephone_number": "708-515-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRYBULA",
        "first_name": "ANETA",
        "credential": "RN, BSN, MSN, AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.021360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANETA",
            "last_name": "MUCHA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.