Individual provider Active NPI

Jevonne Renee Horne

  • Licensed Practical Nurse
  • Chicago, IL
National Provider Identifier
1578106514
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043069789 Issued in IL
Practice address
140 N Ashland Ave
Chicago, IL 60607-1802
Phone
(312) 850-0050
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043069789 IL Primary

Addresses

Primary practice location

140 N Ashland Ave
Chicago, IL 60607-1802

Mailing address

140 N Ashland Ave
Chicago, IL 60607-1802
Phone (312) 633-4977

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043069789ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1578106514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071802",
            "telephone_number": "312-633-4977",
            "fax_number": "312-850-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071802",
            "telephone_number": "312-850-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNE",
        "first_name": "JEVONNE",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043069789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.