Individual provider Active NPI

Theresa Petrea Frank, APN

  • Family Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1235497405
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209001423 Issued in IL
Practice address
675 Varsity Dr
Elgin, IL 60120-8176
Phone
(847) 741-2600
NPI assigned
Apr 25, 2012
Last updated
Apr 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209001423 IL Primary

Addresses

Primary practice location

675 Varsity Dr
Elgin, IL 60120-8176

Mailing address

78 Jefferson LN
Cary, IL 60013-1887
Phone (847) 121-3511

Other names 1

  • Theresa Petrea Carrigan 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

State licenses

LicenseStateTypeSpecialty
209001423ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1235497405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 JEFFERSON LN",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600131887",
            "telephone_number": "847-121-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 VARSITY DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601208176",
            "telephone_number": "847-741-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANK",
        "first_name": "THERESA",
        "middle_name": "PETREA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209001423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "CARRIGAN",
            "middle_name": "PETREA",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.