Individual provider Active NPI

Jessica Loren Antoni, APN

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1700276995
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012156 Issued in IL
Practice address
4848 W Irving Park Rd
Chicago, IL 60641-2718
Phone
(773) 724-6200
Fax
(773) 866-8015
NPI assigned
Jan 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209012156 IL Primary

Addresses

Primary practice location

4848 W Irving Park Rd
Chicago, IL 60641-2718

Mailing address

213 N Racine Ave
Suite 100
Chicago, IL 60607-1644
Phone (312) 733-9730

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

State licenses

LicenseStateTypeSpecialty
209012156ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1700276995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N RACINE AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071644",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412718",
            "telephone_number": "773-724-6200",
            "fax_number": "773-866-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONI",
        "first_name": "JESSICA",
        "middle_name": "LOREN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012156",
            "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 Apr 20, 2016; 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.