Active NPI
Patricia Ann Lueders, APN/CNP
- Adult Health Nurse Practitioner
- Rolling Meadows, IL
National Provider Identifier
1447386164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 209005835
- Practice address
- 4225 Kirchoff Road
Rolling Meadows, IL 60008 - Phone
- (847) 397-2400
- Fax
- (847) 397-2414
- NPI assigned
- Feb 26, 2007
- Last updated
- Dec 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209-005835 | IL | |
| Adult Health Nurse Practitioner | 363LA2200X | 209005835 | IL | Primary |
Addresses
Primary practice location
4225 Kirchoff Road
Rolling Meadows, IL 60008
Mailing address
4225 Kirchoff Road
Rolling Meadows, IL 60008
Phone (847) 397-2400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02233037 | Other | IL | BLUE CROSS BLUE SHIELD IL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-005835 | IL | MD | Nurse Practitioner |
| 209005835 | IL | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418860800000",
"number": "1447386164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4225 KIRCHOFF ROAD",
"city": "ROLLING MEADOWS",
"state": "IL",
"postal_code": "60008",
"telephone_number": "847-397-2400",
"fax_number": "847-397-2414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4225 KIRCHOFF ROAD",
"city": "ROLLING MEADOWS",
"state": "IL",
"postal_code": "60008",
"telephone_number": "847-397-2400",
"fax_number": "847-397-2414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUEDERS",
"first_name": "PATRICIA",
"middle_name": "ANN",
"credential": "APN/CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2014-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209-005835",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "209005835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD IL",
"identifier": "02233037",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rolling Meadows, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.