Individual provider Active NPI

Ellen Han Nathanson, APRN, CNP

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1417398777
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209022372 Issued in IL
Practice address
633 Emerson St
Evanston, IL 60208-0844
Phone
(847) 491-8100
Fax
(847) 491-5919
NPI assigned
Jul 15, 2013
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209022372 IL Primary
Family Nurse Practitioner 363LF0000X 209.022372 IL

Addresses

Primary practice location

633 Emerson St
Evanston, IL 60208-0844

Mailing address

633 Emerson St
Evanston, IL 60208-0844
Phone (847) 491-8100

Other names 1

  • Ellen A. Hansen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210210000929 IL Practitioner - Nurse Practitioner 3274756242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209022372ILMDNurse Practitioner
209.022372ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 13, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 13, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Howard Brown Health Center Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

633 Emerson St
Evanston, IL 60208
Phone (847) 491-2151

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1417398777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 EMERSON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602080844",
            "telephone_number": "847-491-8100",
            "fax_number": "847-491-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 EMERSON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602080844",
            "telephone_number": "847-491-8100",
            "fax_number": "847-491-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHANSON",
        "first_name": "ELLEN",
        "middle_name": "HAN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022372",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "HANSEN",
            "middle_name": "A.",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.