Bianca L Kavanaugh, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209008747 Issued in IL

Practice address

28201 Diehl Rd
Warrenville, IL 60555-3934

Phone

(630) 657-5555

NPI assigned

Aug 15, 2011

Last updated

Oct 29, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1568741072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 S STATE ST APT 700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052976",
            "telephone_number": "312-590-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28201 DIEHL RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553934",
            "telephone_number": "630-657-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "BIANCA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209008747",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041352957",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mason Christian Justice, AS
• Tiffany R Kadow, M.D.
• Michael Kahn, MD
• Cassidy Lynn Kaput, OTD, OTR/L
• Mary J Katsahnias, LCSW
• Lauren Kehoe
• Starlene Kelley, LCSW, CADC
• Ana Clara Kenahan
• Christy M Kesslering, M.D.
• Viraj Mohan Ketkar, DDS

• Family Nurse Practitioner in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.