Individual provider Active NPI

Nancy Ann Olsen, APN

  • Clinical Nurse Specialist
  • Evergreen Park, IL
National Provider Identifier
1588869200
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
209003255 Issued in IL
Practice address
2800 W 95TH St
Evergreen Park, IL 60805-2701
Phone
(708) 229-6067
Fax
(708) 229-6065
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 209003255 IL
Ostomy Care Registered Nurse 163WX1500X 209003255 IL
Clinical Nurse Specialist 364S00000X 209003255 IL Primary

Addresses

Primary practice location

2800 W 95TH St
Evergreen Park, IL 60805-2701

Mailing address

11413 Foxwoods CT
Oak Lawn, IL 60453-7115
Phone (708) 229-6067

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
209003255ILMDOstomy Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1588869200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11413 FOXWOODS CT",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604537115",
            "telephone_number": "708-229-6067",
            "fax_number": "708-229-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052701",
            "telephone_number": "708-229-6067",
            "fax_number": "708-229-6065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "IL",
            "license": "209003255",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "IL",
            "license": "209003255",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209003255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.