Individual provider Active NPI

Joy C McKenna, APN

  • Family Nurse Practitioner
  • Joliet, IL
National Provider Identifier
1477856466
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.008507 Issued in IL
Practice address
1200 Maple Rd
Joliet, IL 60432-1439
Phone
(815) 740-1100
NPI assigned
Dec 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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 209.008507 IL Primary

Addresses

Primary practice location

1200 Maple Rd
Joliet, IL 60432-1439

Mailing address

4821 W 106TH St
Oak Lawn, IL 60453-5232
Phone (708) 217-6548

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
I20110425000390 IL Practitioner - Nurse Practitioner 6406031160 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.008507ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Em Strategies,LTD. CurrentSince Nov 20, 2010 Accepting new patients

Locations

1200 Maple Rd
Joliet, IL 60432
Phone (815) 740-1100

12701 W 143rd St
Lockport, IL 60491
Phone (708) 364-6337

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1477856466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 W 106TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535232",
            "telephone_number": "708-217-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MAPLE RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604321439",
            "telephone_number": "815-740-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JOY",
        "middle_name": "C",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.008507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.