Individual provider Active NPI

Suzanne Kujawa, APN

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1316174154
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209007613041353625 Issued in IL
Practice address
2300 N Childrens PLZ
Chicago, IL 60614-3363
Phone
(773) 880-4000
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X 041353625 IL
Pediatric Nurse Practitioner 363LP0200X 209007613041353625 IL Primary

Addresses

Primary practice location

2300 N Childrens PLZ
Chicago, IL 60614-3363

Mailing address

3550 N Lake Shore Dr
#304
Chicago, IL 60657-1944

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041353625ILMDNeonatal Intensive Care Registered Nurse
209007613041353625ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245369600000",
    "number": "1316174154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N LAKE SHORE DR",
            "address_2": "#304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N CHILDRENS PLZ",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUJAWA",
        "first_name": "SUZANNE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2009-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "IL",
            "license": "041353625",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209007613041353625",
            "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 Jun 19, 2009; 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.