Angela Sue Peters, NURSE PRACTITIONER A

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

277.000596 Issued in IL

Practice address

642 Indian Ridge Dr
Antioch, IL 60002

Phone

(847) 961-2875

NPI assigned

Oct 29, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eh2 Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Antioch, IL
  • NPI 1114502721
  NPD Authorized official
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD (past)
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

{
    "created_epoch": "1319846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1407132897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 INDIAN RIDGE DR",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600023102",
            "telephone_number": "847-961-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 INDIAN RIDGE DR",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "60002",
            "telephone_number": "847-961-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ANGELA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-29",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-009096",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277.000596",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WI",
            "license": "4674-33",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.eh2psych.com",
            "affiliation": "N",
            "endpointDescription": "company website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "6615 Grand Ave",
            "city": "Gurnee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600314591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Novacek, LCSW
• Lena Ochoa
• Oneopto Il 1 PLLC
• Orchard Medical Center SC
• Gavin J Patterson, PT, DPT
• Positive Pathways
• Jessica L Quirini
• Janet Racina
• Joanne Macpherson Rae
• Kelly M Ratajczak, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Antioch, IL
• Providers in Antioch, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.