Active NPI
Preethi Abraham
- Gerontology Nurse Practitioner
- Chicago, IL
National Provider Identifier
1235978727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 209.029605
- Practice address
- 6300 N Lincoln Avenue
Chicago, IL 60659 - Phone
- (773) 681-0260
- NPI assigned
- May 23, 2024
- Last updated
- May 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 209.029605 | IL | Primary |
Addresses
Primary practice location
6300 N Lincoln Avenue
Chicago, IL 60659
Mailing address
9010 Mason Ave
Morton Grove, IL 60053
Phone (733) 822-9366
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
| License | State | Type | Specialty |
|---|---|---|---|
| 209.029605 | IL | MD | Gerontology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1235978727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9010 MASON AVE",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "60053",
"telephone_number": "733-822-9366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6300 N LINCOLN AVENUE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60659",
"telephone_number": "773-681-0260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRAHAM",
"first_name": "PREETHI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-23",
"last_updated": "2024-05-23",
"certification_date": "2024-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IL",
"license": "209.029605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.