Active NPI
Robin Wilson
- Licensed Practical Nurse
- Maywood, IL
National Provider Identifier
1619597291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043107846
- Practice address
- 842 S 18TH Ave
Maywood, IL 60153-1706 - Phone
- (773) 849-5648
- NPI assigned
- Apr 23, 2020
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043107846 | IL | Primary |
Addresses
Primary practice location
842 S 18TH Ave
Maywood, IL 60153-1706
Mailing address
842 S 18TH Ave
Maywood, IL 60153-1706
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | joneseve17@gamil.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 043107846 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587600000000",
"number": "1619597291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "842 S 18TH AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601531706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 S 18TH AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601531706",
"telephone_number": "773-849-5648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-23",
"last_updated": "2020-04-23",
"certification_date": "2020-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043107846",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "joneseve17@gamil.com",
"affiliation": "N",
"address_1": "842 S 18th Ave",
"city": "Maywood",
"state": "IL",
"country_code": "US",
"postal_code": "601531706",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.