Maria Iana Baczek, MSN, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041429671 Issued in IL

Practice address

2650 Ridge Ave
Evanston, IL 60201-1700

Phone

(847) 982-5282

NPI assigned

Mar 7, 2020

Last updated

Mar 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Iana Samson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1427683705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4018 N CENTRAL PARK AVE APT 3S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606182136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-982-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACZEK",
        "first_name": "MARIA IANA",
        "credential": "MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041429671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA IANA",
            "last_name": "SAMSON",
            "credential": "MSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Evanston, IL
• Providers in Evanston, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2020; 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.