Individual provider Active NPI

Vicki Ann Andreoni, DNP, RN, CPNP

  • Pediatric Nurse Practitioner
  • Maywood, IL
National Provider Identifier
1710920962
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209-001982 Issued in IL
Practice address
807 S 1St Ave
Maywood, IL 60153-2307
Phone
(708) 449-9529
Fax
(708) 449-9525
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209-001982 IL Primary

Addresses

Primary practice location

807 S 1St Ave
Maywood, IL 60153-2307

Mailing address

300 S Peck Ave
La Grange, IL 60525-2171
Phone (708) 352-2742

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 Pediatric Nurse Practitioner, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
209-001982ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University School of Nursing - School-Based Health Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297209600000",
    "number": "1710920962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S PECK AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252171",
            "telephone_number": "708-352-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532307",
            "telephone_number": "708-449-9529",
            "fax_number": "708-449-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREONI",
        "first_name": "VICKI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209-001982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.