Individual provider Active NPI

Loreal Ratliff

  • Pediatric Registered Nurse
  • Lynwood, IL
National Provider Identifier
1619686334
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
041430968 Issued in IL
Practice address
2511 Cedar Glen Dr N
Lynwood, IL 60411-1512
Phone
(708) 304-3168
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 041430968 IL Primary

Addresses

Primary practice location

2511 Cedar Glen Dr N
Lynwood, IL 60411-1512

Mailing address

2511 Cedar Glen Dr N
Lynwood, IL 60411-1512
Phone (708) 304-3168

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

LicenseStateTypeSpecialty
041430968ILMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Homegrown Health Care, Inc. CurrentSince Jul 2, 2023 Accepting new patients
LHK Group LLC Current Accepting new patients

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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1619686334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 CEDAR GLEN DR N",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604111512",
            "telephone_number": "708-304-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 CEDAR GLEN DR N",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604111512",
            "telephone_number": "708-304-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "LOREAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "IL",
            "license": "041430968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.