Individual provider Active NPI

Justin Conrad Koerner, APRN, CNP

  • Nurse Practitioner
  • Lake Forest, IL
National Provider Identifier
1245095751
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209029414 Issued in IL
Practice address
1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone
(847) 534-3278
Fax
(847) 535-8590
NPI assigned
Feb 14, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209029414 IL Primary

Addresses

Primary practice location

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone (847) 534-3278

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
I20240415003661 IL Practitioner - Nurse Practitioner 6608215264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500

1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

1200 N Westmoreland Rd
Suite 100
Lake Forest, IL 60045-1601
Phone (847) 735-8500

600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

870 N Milwaukee Ave
Vernon Hills, IL 60061-1521

Hospital & facility affiliations

  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Apr 3, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Apr 3, 2024 Accepting new patients
Central Dupage Physician Group PastSince Mar 24, 2024 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1000 N Westmoreland Rd
#1
Lake Forest, IL 60045
Phone (847) 534-3278

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1245095751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-534-3278",
            "fax_number": "847-535-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-534-3278",
            "fax_number": "847-535-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "JUSTIN",
        "middle_name": "CONRAD",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209029414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.