Individual provider Active NPI

Kristen Terese Repta

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1245915495
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.004537 Issued in IL
Practice address
2033 W Roscoe St
Chicago, IL 60618-6386
Phone
(312) 479-7853
NPI assigned
Jun 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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 277.004537 IL Primary

Addresses

Primary practice location

2033 W Roscoe St
Chicago, IL 60618-6386

Mailing address

2033 W Roscoe St
Chicago, IL 60618-6386
Phone (312) 479-7853

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
209027489ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1245915495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186386",
            "telephone_number": "312-479-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 W ROSCOE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606186386",
            "telephone_number": "312-479-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPTA",
        "first_name": "KRISTEN",
        "middle_name": "TERESE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.004537",
            "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 Sep 10, 2026; 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.