Individual provider Active NPI

Mary Therese Lyons, RN, APN

  • Critical Care Medicine Clinical Nurse Specialist
  • Chicago, IL
National Provider Identifier
1649475559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X
Practice address
1901 W Harrison St
Chicago, IL 60612-3714
Phone
(312) 864-6000
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Clinical Nurse Specialist 364SC0200X IL Primary

Addresses

Primary practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

9808 S Kolin Ave
Oak Lawn, IL 60453-3546
Phone (708) 499-0661

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)
Enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
209-001267ILMDCritical Care Medicine Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649475559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 S KOLIN AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533546",
            "telephone_number": "708-499-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123714",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "RN, APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.