Active NPI
Susan Watts
- Registered Nurse
- Lake Bluff, IL
National Provider Identifier
1508305079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041327952
- Practice address
- 28650 Braeloch CT
Lake Bluff, IL 60044-3004 - Phone
- (847) 283-9852
- NPI assigned
- Feb 16, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041327952 | IL | Primary |
Addresses
Primary practice location
28650 Braeloch CT
Lake Bluff, IL 60044-3004
Mailing address
28650 Braeloch CT
Lake Bluff, IL 60044-3004
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041327952 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1508305079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28650 BRAELOCH CT",
"city": "LAKE BLUFF",
"state": "IL",
"postal_code": "600443004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28650 BRAELOCH CT",
"city": "LAKE BLUFF",
"state": "IL",
"postal_code": "600443004",
"telephone_number": "847-283-9852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-16",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041327952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Bluff, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.