Individual provider Active NPI

Julie Pak, FNP-C

  • Family Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1255793162
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014033 Issued in IL
Practice address
4711 Golf Rd
Suite 1250
Skokie, IL 60076-1224
Phone
(847) 235-6033
Fax
(847) 235-6033
NPI assigned
Mar 22, 2016
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 209014033 IL Primary

Addresses

Primary practice location

4711 Golf Rd
Suite 1250
Skokie, IL 60076-1224

Mailing address

4711 Golf Rd
Suite 1250
Skokie, IL 60076-1224
Phone (847) 235-6033

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
I20160330001213 IL Practitioner - Nurse Practitioner 7113224502 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center CurrentSince Jul 22, 2017 Accepting new patients
Vpa PC CurrentSince Dec 17, 2017 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients
City of Hope Medical Group of Illinois PLLC CurrentSince Sep 1, 2016 Accepting new patients
Vpa PC CurrentSince Dec 17, 2017 Accepting new patients
Lawndale Christian Health Center CurrentSince Jul 22, 2017 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients

Locations

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

4696 Paysphere Cir
Chicago, IL 60674

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1255793162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1250",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-235-6033",
            "fax_number": "847-235-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 1250",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-235-6033",
            "fax_number": "847-235-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "JULIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.