Individual provider Active NPI

Christina F Kopeika, C.N.P.

  • Nurse Practitioner
  • Highland Park, IL
National Provider Identifier
1538191978
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-005654 Issued in IL
Practice address
480 Elm PL
Suite 203
Highland Park, IL 60035-2538
Phone
(847) 433-0404
Fax
(847) 433-1389
NPI assigned
Jul 7, 2006
Last updated
Aug 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209-005654 IL Primary

Addresses

Primary practice location

480 Elm PL
Suite 203
Highland Park, IL 60035-2538

Mailing address

480 Elm PL
Suite 203
Highland Park, IL 60035-2538
Phone (847) 433-0404

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-005654ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1538191978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 ELM PL",
            "address_2": "SUITE 203",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352538",
            "telephone_number": "847-433-0404",
            "fax_number": "847-433-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ELM PL",
            "address_2": "SUITE 203",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352538",
            "telephone_number": "847-433-0404",
            "fax_number": "847-433-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPEIKA",
        "first_name": "CHRISTINA",
        "middle_name": "F",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-005654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.