Active NPI
Susan Dunne
- Psychiatric/Mental Health Nurse Practitioner
- La Grange Park, IL
National Provider Identifier
1528440930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 277003243
- Practice address
- 321 N la Grange Rd
La Grange Park, IL 60526-5622 - Phone
- (708) 745-5277
- NPI assigned
- Jun 22, 2015
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 277003243 | IL | Primary |
Addresses
Primary practice location
321 N la Grange Rd
La Grange Park, IL 60526-5622
Mailing address
5220 East Ave
Countryside, IL 60525-3133
Phone (708) 745-5277
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241210000446 | IL | Order and Referring Only - Nurse Practitioner | 7012229933 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277003243 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1528440930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5220 EAST AVE",
"city": "COUNTRYSIDE",
"state": "IL",
"postal_code": "605253133",
"telephone_number": "708-745-5277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 N LA GRANGE RD",
"city": "LA GRANGE PARK",
"state": "IL",
"postal_code": "605265622",
"telephone_number": "708-745-5277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNNE",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-22",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "277003243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Grange Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.