Individual provider Active NPI

Kathy Bettinardi Angres, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lisle, IL
National Provider Identifier
1639417736
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277.003268 Issued in IL
Practice address
1500 Eisenhower LN Ste 900
Lisle, IL 60532-2135
Phone
(708) 822-2555
NPI assigned
Jan 24, 2013
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277.003268 IL Primary

Addresses

Primary practice location

1500 Eisenhower LN Ste 900
Lisle, IL 60532-2135

Mailing address

1047 Braemoor Dr
Downers Grove, IL 60515-5524
Phone (708) 822-2255

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
I20241226001709 IL Practitioner - Nurse Practitioner 5799212023 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277.003268ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Psychiatric/Mental Health CurrentSince Jan 13, 2025 Accepting new patients
Psychology Specialists LTD Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

1500 Eisenhower Ln
Unit E
Lisle, IL 60532

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1639417736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 BRAEMOOR DR",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155524",
            "telephone_number": "708-822-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EISENHOWER LN STE 900",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605322135",
            "telephone_number": "708-822-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTINARDI ANGRES",
        "first_name": "KATHY",
        "name_prefix": "Mrs.",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-24",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277.003268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

Verify at the official NPI Registry.