Individual provider Active NPI

Donna D Wittert, APN CNP CDE

  • Nurse Practitioner
  • Northbrook, IL
National Provider Identifier
1447238910
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2090040111 Issued in IL
Practice address
3300 Milwaukee Ave
Northbrook, IL 60062-7126
Phone
(847) 795-9600
Fax
(847) 795-9600
NPI assigned
Jan 5, 2006
Last updated
Mar 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2090040111 IL Primary

Addresses

Primary practice location

3300 Milwaukee Ave
Northbrook, IL 60062-7126

Mailing address

3300 Milwaukee Ave
Northbrook, IL 60062-7126
Phone (847) 795-9600

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2090040111ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1447238910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 MILWAUKEE AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627126",
            "telephone_number": "847-795-9600",
            "fax_number": "847-795-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MILWAUKEE AVE",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600627126",
            "telephone_number": "847-795-9600",
            "fax_number": "847-795-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTERT",
        "first_name": "DONNA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "APN CNP CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-05",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "2090040111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.