Active NPI
Sheila M Provenzano, R.N.
- Registered Nurse
- Elk Grove Village, IL
National Provider Identifier
1578764189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041-320930
- Practice address
- 555 Biesterfield Rd
Elk Grove Village, IL 60007-3306 - Phone
- (847) 690-1776
- Fax
- (847) 690-1777
- NPI assigned
- May 30, 2007
- Last updated
- Oct 6, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041-320930 | IL | Primary |
Addresses
Primary practice location
555 Biesterfield Rd
Elk Grove Village, IL 60007-3306
Mailing address
555 Biesterfield Rd
Elk Grove Village, IL 60007-3306
Phone (847) 690-1776
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041-320930 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1578764189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 BIESTERFIELD RD",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073306",
"telephone_number": "847-690-1776",
"fax_number": "847-690-1777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 BIESTERFIELD RD",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073306",
"telephone_number": "847-690-1776",
"fax_number": "847-690-1777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROVENZANO",
"first_name": "SHEILA",
"middle_name": "M",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041-320930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.