Active NPI
Stephanie Patrice Coleman
- Registered Nurse
- Lisle, IL
National Provider Identifier
1366110207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041327916
- Practice address
- 6000 Oakwood Dr Apt 3L
Lisle, IL 60532-3023 - Phone
- (773) 502-4604
- NPI assigned
- Sep 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041327916 | IL | Primary |
Addresses
Primary practice location
6000 Oakwood Dr Apt 3L
Lisle, IL 60532-3023
Mailing address
6000 Oakwood Dr Apt 3L
Lisle, IL 60532-3023
Phone (773) 502-4604
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
| License | State | Type | Specialty |
|---|---|---|---|
| 041327916 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630713600000",
"number": "1366110207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6000 OAKWOOD DR APT 3L",
"city": "LISLE",
"state": "IL",
"postal_code": "605323023",
"telephone_number": "773-502-4604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 OAKWOOD DR APT 3L",
"city": "LISLE",
"state": "IL",
"postal_code": "605323023",
"telephone_number": "773-502-4604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "STEPHANIE",
"middle_name": "PATRICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-04",
"last_updated": "2021-09-04",
"certification_date": "2021-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041327916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lisle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.