Individual provider Active NPI

Valerie Jean Matthiesen, NP

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1366629172
Registry record updated Feb 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209003504 Issued in IL
Practice address
734 W 47TH St
Chicago, IL 60609-4411
Phone
(773) 537-3960
Fax
(773) 536-2460
NPI assigned
Jan 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209003504 IL Primary

Addresses

Primary practice location

734 W 47TH St
Chicago, IL 60609-4411

Mailing address

Uic College of Nursing (Mc802) 845 S. Damen Avenue
Room 760
Chicago, IL 60612
Phone (312) 996-1644

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)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265500800000",
    "number": "1366629172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UIC COLLEGE OF NURSING (MC802) 845 S. DAMEN AVENUE",
            "address_2": "ROOM 760",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-996-1644",
            "fax_number": "312-996-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 W 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606094411",
            "telephone_number": "773-537-3960",
            "fax_number": "773-536-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHIESEN",
        "first_name": "VALERIE",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2010-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209003504",
            "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 Feb 7, 2010; 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.