Kirsten Elizabeth Pelka, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209.009656 Issued in IL

Practice address

5425 W Addison St
Old Irving Park Community Clinic
Chicago, IL 60641-3203

Phone

(773) 427-0298

NPI assigned

Nov 26, 2012

Sex

Female

Sole proprietor

Yes

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1639413974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W ADDISON ST",
            "address_2": "OLD IRVING PARK COMMUNITY CLINIC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413203",
            "telephone_number": "773-427-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W ADDISON ST",
            "address_2": "OLD IRVING PARK COMMUNITY CLINIC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606413203",
            "telephone_number": "773-427-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKA",
        "first_name": "KIRSTEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.009656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherish Pelegrino, PT
• Diane Pelegris, LCSW
• Fernand Pelin, PT
• Silvia M Pelini, O.D.
• Colleen H Pelino, DO
• April Pelkey
• Jamie Dee Pellar, MSW, ACSW,LCSW
• Janice Marie Pellecchia, BCBA
• Don Pellegrini, DN
• Elizabeth Rose Pellegrini, PA-C

• Adult Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.