Individual provider Active NPI

Ernestine Monica Koehn, FNP-BC

  • Family Nurse Practitioner
  • Mount Prospect, IL
National Provider Identifier
1467710046
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.009215 Issued in IL
Practice address
800 E. Northwest Highway
Mt. Prospect, IL 60056
Phone
(847) 299-4952
Fax
(847) 299-4952
NPI assigned
May 2, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.009215 IL Primary

Addresses

Primary practice location

800 E. Northwest Highway
Mt. Prospect, IL 60056

Mailing address

800 E. Northwest Highway
Mt. Prospect, IL 60056
Phone (847) 867-7924

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
I20120531000313 IL Practitioner - Nurse Practitioner 9335302363 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Care Home Physicians LLCGroup PAC ID 7517399942, 7 clinicians

Practice addresses (Care Compare)

2250 E Devon Ave
Suite 217
Des Plaines, IL 60018-4526
Phone (847) 238-8300

6044 N Nassau Ave
Chicago, IL 60631-2649
Phone (847) 238-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.009215ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anointed Hands Physical Therapy and Fitness Center CurrentSince May 9, 2019 Accepting new patients
Infinite Care Home Physicians LLC CurrentSince Jun 15, 2023 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients
Osf Multi-Specialty Group Past Accepting new patients

Locations

2250 E Devon Ave
Ste 217
Des Plaines, IL 60018
Phone (847) 238-8300

1316 N Cedar Rd
New Lenox, IL 60451
Phone (773) 470-3743

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467710046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E. NORTHWEST HIGHWAY",
            "city": "MT. PROSPECT",
            "state": "IL",
            "postal_code": "60056",
            "telephone_number": "847-867-7924",
            "fax_number": "773-752-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E. NORTHWEST HIGHWAY",
            "city": "MT. PROSPECT",
            "state": "IL",
            "postal_code": "60056",
            "telephone_number": "847-299-4952",
            "fax_number": "847-299-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "ERNESTINE",
        "middle_name": "MONICA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.009215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.