Individual provider Active NPI

Kathleen Vinik

  • Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1548019078
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209029868 Issued in IL
Practice address
801 S Washington St
Naperville, IL 60540-7499
Phone
(630) 527-3000
NPI assigned
May 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.029868 IL
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 209029868 IL Primary

Addresses

Primary practice location

801 S Washington St
Naperville, IL 60540-7499

Mailing address

801 S Washington St
Naperville, IL 60540-7499

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
I20240703000824 IL Practitioner - Nurse Practitioner 7416491246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.029868ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Jun 20, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 20, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

155 E Brush Hill Rd
Elmhurst, IL 60126
Phone (331) 221-3521

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

801 S Washington St
Naperville, IL 60540
Phone (312) 355-0450

Interoperability endpoints

  • Direct secure messaging: kvinik256233@direct.edward.org

Organizations & group practices 2

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 1

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": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1548019078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WASHINGTON ST",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407499",
            "telephone_number": "630-527-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINIK",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.029868",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209029868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.