Individual provider Active NPI

Roweine Q. Staszcuk, N.P.

  • Adult Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1699857243
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209003325 Issued in IL
Practice address
10 S Kedzie Ave
Room 206
Chicago, IL 60612-2706
Phone
(312) 746-6833
Fax
(312) 746-9049
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209003325 IL Primary

Addresses

Primary practice location

10 S Kedzie Ave
Room 206
Chicago, IL 60612-2706

Mailing address

10 S Kedzie Ave
RM 206
Chicago, IL 60612-2706
Phone (773) 775-1589

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
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1699857243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S KEDZIE AVE",
            "address_2": "RM 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122706",
            "telephone_number": "773-775-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S KEDZIE AVE",
            "address_2": "ROOM 206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122706",
            "telephone_number": "312-746-6833",
            "fax_number": "312-746-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STASZCUK",
        "first_name": "ROWEINE",
        "middle_name": "Q.",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209003325",
            "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 Nov 22, 2017; 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.