Urshala Palmer

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041414568 Issued in IL

Practice address

19801 Governors Hwy Ste 140
Flossmoor, IL 60422-4363

Phone

(773) 614-4101

NPI assigned

Oct 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1666915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1710694849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20015 S LAGRANGE RD # 1018",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233104",
            "telephone_number": "773-614-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801 GOVERNORS HWY STE 140",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604224363",
            "telephone_number": "773-614-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "URSHALA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-28",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041414568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@premiumpractitioners.com",
            "affiliation": "Y",
            "endpointDescription": "Office email",
            "affiliationName": "Premium Practitioners Plus Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19801 Governors Hwy Ste 140",
            "city": "Flossmoor",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604224363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.