Individual provider Active NPI

Lynnette Mraz, R.N.

  • General Practice Registered Nurse
  • Chicago, IL
National Provider Identifier
1346603305
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
041169504 Issued in IL
Practice address
310 N Loomis St
Chicago, IL 60607-1147
Phone
(312) 733-0883
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X
General Practice Registered Nurse 163WG0000X 041169504 IL Primary

Addresses

Primary practice location

310 N Loomis St
Chicago, IL 60607-1147

Mailing address

310 N Loomis St
Chicago, IL 60607-1147
Phone (312) 733-0883

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041169504ILMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Eyas Landing, Inc. 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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1346603305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-733-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N LOOMIS ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071147",
            "telephone_number": "312-733-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MRAZ",
        "first_name": "LYNNETTE",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IL",
            "license": "041169504",
            "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 Mar 29, 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.

Verify at the official NPI Registry.