Individual provider Active NPI

Laurie Zack, APN, FNP-BC

  • Family Nurse Practitioner
  • Oak Park, IL
National Provider Identifier
1396149449
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209011485 Issued in IL
Practice address
525 S Scoville Ave
Unit 1
Oak Park, IL 60304-1403
Phone
(815) 531-2222
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209011485 IL Primary

Addresses

Primary practice location

525 S Scoville Ave
Unit 1
Oak Park, IL 60304-1403

Mailing address

525 S Scoville Ave
Unit 1
Oak Park, IL 60304-1403
Phone (815) 531-2222

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
209011485ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1396149449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 S SCOVILLE AVE",
            "address_2": "UNIT 1",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041403",
            "telephone_number": "815-531-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 S SCOVILLE AVE",
            "address_2": "UNIT 1",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041403",
            "telephone_number": "815-531-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACK",
        "first_name": "LAURIE",
        "name_prefix": "Ms.",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.