Individual provider Active NPI

Michelle Stoklosa, APN

  • Family Nurse Practitioner
  • Lemont, IL
National Provider Identifier
1588196802
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015492 Issued in IL
Practice address
14244 McCarthy Rd
Lemont, IL 60439-9393
Phone
(630) 754-0141
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015492 IL Primary

Addresses

Primary practice location

14244 McCarthy Rd
Lemont, IL 60439-9393

Mailing address

7405 W Ute LN
Palos Heights, IL 60463-2045
Phone (708) 227-3654

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
I20171113003523 IL Practitioner - Nurse Practitioner 3173889854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209015492ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jacek Grela M.D., S.C. CurrentSince Aug 12, 2017 Accepting new patients
Adult Primary Care Center, LTD. PastSince Aug 12, 2017 Accepting new patients

Locations

14244 McCarthy Rd
Lemont, IL 60439
Phone (630) 754-0141

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEFGCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FEFGCA/Endpoint/FEFGCA

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.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1588196802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 W UTE LN",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632045",
            "telephone_number": "708-227-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14244 MCCARTHY RD",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604399393",
            "telephone_number": "630-754-0141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKLOSA",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

Verify at the official NPI Registry.