Individual provider Active NPI

Denise Castle, FNP-C

  • Family Nurse Practitioner
  • Tinley Park, IL
National Provider Identifier
1609343763
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018398 Issued in IL
Practice address
18210 La Grange Rd
Tinley Park, IL 60487-7722
Phone
(708) 478-4372
NPI assigned
Oct 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corporate Health Clinic/Center 261QC1800X 209018398 IL
Family Nurse Practitioner 363LF0000X 209018398 IL Primary

Addresses

Primary practice location

18210 La Grange Rd
Tinley Park, IL 60487-7722

Mailing address

1007 Roslyn Rd
Olympia Fields, IL 60461-1630
Phone (708) 845-8873

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
I20190102000174 IL Practitioner - Nurse Practitioner 9830434422 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209018398ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jan 25, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 25, 2019 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

18210 La Grange Rd
Tinley Park, IL 60487
Phone (708) 422-7715

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": "1540512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1609343763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 ROSLYN RD",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611630",
            "telephone_number": "708-845-8873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18210 LA GRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877722",
            "telephone_number": "708-478-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTLE",
        "first_name": "DENISE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-26",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "IL",
            "license": "209018398",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.