Individual provider Active NPI

Nicole Schram

  • Family Nurse Practitioner
  • Oak Park, IL
National Provider Identifier
1578095147
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015308 Issued in IL
Practice address
3 Erie CT
Oak Park, IL 60302-2519
Phone
(708) 763-3233
NPI assigned
Apr 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209015308 IL
Family Nurse Practitioner 363LF0000X 209015308 IL Primary

Addresses

Primary practice location

3 Erie CT
Oak Park, IL 60302-2519

Mailing address

3 Erie CT
Oak Park, IL 60302-2519
Phone (708) 763-3233

Other identifiers 1

IdentifierTypeStateIssuer
1578095147OtherNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL nlawrence@epmg.com

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
I20170712003660 IL Practitioner - Nurse Practitioner 9234408857 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Lake Immediate Care Physicians LTD.Group PAC ID 2961783139, 17 clinicians

Practice addresses (Care Compare)

525 E Congress Pkwy
Suite 100
Crystal Lake, IL 60014-6271
Phone (626) 327-6795

Hospital & facility affiliations

  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Lake Immediate Care Physicians LTD. CurrentSince Feb 3, 2020 Accepting new patients
Tri-County Emergency Physicians, LTD CurrentSince Feb 3, 2020 Accepting new patients
Harvey Emergency Physicians, PLLC Nurse Practitioner CurrentSince Aug 12, 2019 Accepting new patients
Advocate Health and Hospitals Corporation PastSince Feb 3, 2020 Accepting new patients

Locations

525 E Congress Pkwy
Ste 100
Crystal Lake, IL 60014
Phone (626) 327-6795

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Organizations & group practices 4

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": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1578095147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-763-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-763-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRAM",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-01",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015308",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578095147",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nlawrence@epmg.com",
            "affiliation": "N",
            "address_1": "3 Erie Ct",
            "city": "Oak Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "603022519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.