Meredith Roberts Lacaillade, APN - RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209009922 Issued in IL

Practice address

1849 Green Bay Rd Ste 220
Highland Park, IL 60035-3178

Phone

(847) 433-7660

Fax

(847) 433-7662

NPI assigned

Jun 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Meredith Roberts Wylde Former name

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

Specialty

Nurse Practitioner

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Allergists and Asthma Specialists, LTDGroup PAC ID 9436106085, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Associated Allergists and Asthma Specialists, LTD

  • Allergy Physician
  • Orland Park, IL
  • NPI 1720117823

  IL

  Medicare reassignment Care Compare group NPD
• Ear, Nose & Throat Specialists of Illinois LTD

  • Specialist
  • Park Ridge, IL
  • NPI 1750340949
  NPD (past)

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1275844797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 GREEN BAY RD STE 220",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353178",
            "telephone_number": "847-433-7660",
            "fax_number": "847-433-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 GREEN BAY RD STE 220",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353178",
            "telephone_number": "847-433-7660",
            "fax_number": "847-433-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACAILLADE",
        "first_name": "MEREDITH",
        "middle_name": "ROBERTS",
        "credential": "APN - RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009922",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041405362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "WYLDE",
            "middle_name": "ROBERTS",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Emily Catherine Kubacki, FNP
• Richard Kubes, LMT
• Cinda Kuhn
• Ila P Kurani, MD
• Craig Van Nort Labbate, MD
• Laccura LLC
• William L Laegeler, RPH
• Lake County Immediate Care, LLC
• Lake Shore Foot & Ankle, PC
• Lake Shore Gastroenterology

• All providers in Highland Park, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.