Individual provider Active NPI

Janet Elaine Kanis, RN

  • Registered Nurse
  • Countryside, IL
National Provider Identifier
1386962611
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041212005 Issued in IL
Practice address
9649 W 55TH St
Countryside, IL 60525-3632
Phone
(708) 352-3580
NPI assigned
May 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041212005 IL Primary

Addresses

Primary practice location

9649 W 55TH St
Countryside, IL 60525-3632

Mailing address

921 Highland CT
Downers Grove, IL 60515-2813
Phone (630) 964-0718

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
041212005ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1386962611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 HIGHLAND CT",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152813",
            "telephone_number": "630-964-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9649 W 55TH ST",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605253632",
            "telephone_number": "708-352-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANIS",
        "first_name": "JANET",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-11",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041212005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Countryside, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.