Individual provider Active NPI

Kathleen Raza, AGACNP

  • Acute Care Nurse Practitioner
  • Bolingbrook, IL
National Provider Identifier
1497443915
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0123456789 Issued in IL
Practice address
396 Remington Blvd Ste 140
Bolingbrook, IL 60440-4311
Phone
(630) 495-9356
Fax
(630) 495-9357
NPI assigned
Apr 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0123456789 IL Primary

Addresses

Primary practice location

396 Remington Blvd Ste 140
Bolingbrook, IL 60440-4311

Mailing address

120 W 22ND St
Oak Brook, IL 60523-1557
Phone (630) 573-5000

Other practice location 1

2340 S Highland Ave Ste 160
Lombard, IL 60148-5395
Phone (630) 495-9356

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

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
I20230503003039 IL Practitioner - Nurse Practitioner 2264897826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Inpatient Medicine LLCGroup PAC ID 8022305697, 42 clinicians

Practice addresses (Care Compare)

120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0123456789ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Inpatient Medicine LLC CurrentSince Oct 15, 2025 Accepting new patients

Locations

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

1131 W Jefferson St
Shorewood, IL 60404

Interoperability endpoints

  • Direct secure messaging: kraza55078@direct.acumenmd.com

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.

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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1497443915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231557",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD STE 140",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404311",
            "telephone_number": "630-495-9356",
            "fax_number": "630-495-9357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2340 S Highland Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Lombard",
            "state": "IL",
            "postal_code": "601485395",
            "country_code": "US",
            "telephone_number": "630-495-9356",
            "fax_number": "630-495-9357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZA",
        "first_name": "KATHLEEN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "0123456789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.