Individual provider Active NPI

Katrice Washington

  • Licensed Practical Nurse
  • Chicago, IL
National Provider Identifier
1366027716
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043102998 Issued in IL
Practice address
7510 S Winchester Ave
Chicago, IL 60620-5220
Phone
(773) 799-1808
NPI assigned
Mar 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X
Licensed Practical Nurse 164W00000X 043102998 IL Primary

Addresses

Primary practice location

7510 S Winchester Ave
Chicago, IL 60620-5220

Mailing address

PO Box 424
Hines, IL 60141-0424
Phone (773) 799-1808

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

State licenses

LicenseStateTypeSpecialty
043102998ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1366027716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601410424",
            "telephone_number": "773-799-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7510 S WINCHESTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205220",
            "telephone_number": "773-799-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "KATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043102998",
            "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 16, 2021; 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.