Karen R Boettner, CNM, RN, MSN

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

209-002811 Issued in IL

Practice address

6550 Broadcast Parkway
Loves Park, IL 61111

Phone

(847) 710-1325

NPI assigned

Apr 24, 2006

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)

Enrolled

Credentials

Certified Nurse Midwife, Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1669438230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 BROADCAST PKWY",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611118671",
            "telephone_number": "847-710-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 BROADCAST PARKWAY",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "61111",
            "telephone_number": "847-710-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTNER",
        "first_name": "KAREN",
        "middle_name": "R",
        "credential": "CNM, RN, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-24",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209-002811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bischoff Dentistry, LTD
• Richard Joseph Bischoff, DDS
• Jay Charles Black, OD
• Jason Josef Blake, LCSW
• Benjamin David Blitzblau, PHARMD
• Gingerly Bolalin, P.T.
• Alexis Borodin
• William Tiva Bounthong, LCSW
• Daniel S Bradt, DC
• Rita K. Bramley, RN

• Advanced Practice Midwife in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Advanced Practice Midwife in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.