Active NPI
Teresa Katz
- Family Nurse Practitioner
- Evanston, IL
National Provider Identifier
1255873089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209015004
- Practice address
- 2650 Ridge Ave
Department of Emergency
Evanston, IL 60201-1718 - Phone
- (847) 570-2000
- NPI assigned
- Nov 10, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209015004 | IL | Primary |
Addresses
Primary practice location
2650 Ridge Ave
Department of Emergency
Evanston, IL 60201-1718
Mailing address
2650 Ridge Ave
Department of Emergency
Evanston, IL 60201-1718
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209015004 | Other | IL | STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209015004 | IL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478736000000",
"number": "1255873089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"address_2": "DEPARTMENT OF EMERGENCY",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"address_2": "DEPARTMENT OF EMERGENCY",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011718",
"telephone_number": "847-570-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATZ",
"first_name": "TERESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-10",
"last_updated": "2016-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209015004",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
"identifier": "209015004",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.