Active NPI
Lori Holloway, APN
- Family Nurse Practitioner
- Morton Grove, IL
National Provider Identifier
1386994416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209009125
- Practice address
- 9301 Waukegan Rd
Morton Grove, IL 60053-1313 - Phone
- (800) 323-8622
- NPI assigned
- Sep 17, 2012
- Last updated
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15115 | WI | |
| Family Nurse Practitioner | 363LF0000X | 209009125 | IL | Primary |
Addresses
Primary practice location
9301 Waukegan Rd
Morton Grove, IL 60053-1313
Mailing address
29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900
Other practice location 1
464 Cardinal Ln
Howard, WI 54313-9569
Phone (920) 434-3880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100280383 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lholloway205446@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240617000398 | WI | Practitioner - Nurse Practitioner | 9638323892 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Take Care Health Illinois, P.C. | Family | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Nurse Practitioner
- Arlington Heights, IL
- NPI 1730192022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1386994416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29373 NETWORK PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606731293",
"telephone_number": "847-390-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9301 WAUKEGAN RD",
"city": "MORTON GROVE",
"state": "IL",
"postal_code": "600531313",
"telephone_number": "800-323-8622"
}
],
"practiceLocations": [
{
"address_1": "464 Cardinal Ln",
"address_purpose": "LOCATION",
"city": "Howard",
"state": "WI",
"postal_code": "543139569",
"country_code": "US",
"telephone_number": "920-434-3880",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLLOWAY",
"first_name": "LORI",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-17",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WI",
"license": "15115",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209009125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100280383",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lholloway205446@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "9301 Waukegan Rd",
"city": "Morton Grove",
"state": "IL",
"country_code": "US",
"postal_code": "600531313",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "9301 Waukegan Rd",
"city": "Morton Grove",
"state": "IL",
"country_code": "US",
"postal_code": "600531313",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Morton Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.