Robert Anthony Wisdom, CRNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

209014169 Issued in IL

Practice address

4444 S Prairie Ave
Chicago, IL 60653-3208

Phone

(917) 362-6997

NPI assigned

Aug 16, 2006

Last updated

Apr 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1487767117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 S PRAIRIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533208",
            "telephone_number": "917-362-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 S PRAIRIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533208",
            "telephone_number": "917-362-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NY",
            "license": "350263",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IL",
            "license": "209014169",
            "primary": true
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "942926-6",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wisconsin Mobile Dental Care LLC
• Wisdom of Health
• Wise Behavioral Health Services LTD
• Wise Guys Counseling
• Wise Health Professional Corporation
• Wise Health Professional Corporation
• Wise Mind Psychotherapy

• Neonatal Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Neonatal Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.