Individual provider Active NPI

Patricia Taiwo Arrey Ebot, FNP

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1518516731
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.019885 Issued in IL
Practice address
2036 W Arthur Ave Apt 1
Chicago, IL 60645-5554
Phone
(773) 671-8884
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 209.019885 IL Primary

Addresses

Primary practice location

2036 W Arthur Ave Apt 1
Chicago, IL 60645-5554

Mailing address

2036 W Arthur Ave Apt 1
Chicago, IL 60645-5554
Phone (773) 671-8884

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

LicenseStateTypeSpecialty
209.019885ILMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: patricia.ebot.1@3342.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1518516731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2036 W ARTHUR AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455554",
            "telephone_number": "773-671-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 W ARTHUR AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606455554",
            "telephone_number": "773-671-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBOT",
        "first_name": "PATRICIA",
        "middle_name": "TAIWO ARREY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.