Nanci H Stark, APRN

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

20901978 Issued in IL

Practice address

705 S Kensington Ave
La Grange, IL 60525-2708

Phone

(708) 216-8554

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1629614136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S KENSINGTON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252708",
            "telephone_number": "708-216-8554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S KENSINGTON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252708",
            "telephone_number": "708-216-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "NANCI",
        "middle_name": "H",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "IL",
            "license": "20901978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinaya Ramesh Soundararajan, MD
• Specialty Partners in Anesthesia LLC
• Ashley Speller, DC
• Cristina Nicole Spencer, MA CCC SLPL
• Jenna R. Squillo, BCBA
• Louise Starmann, LCSW
• Kristina Nicole Stepanovic, DO
• Stephen C. Murphy DPM
• Stephen Wallace DDS Inc
• Lisa Stephen

• Gerontology Clinical Nurse Specialist in La Grange, IL
• Providers in La Grange, IL by specialty
• Gerontology Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.