Individual provider Active NPI

Kathleen Trinh

  • Family Nurse Practitioner
  • Waukegan, IL
National Provider Identifier
1720635170
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209019855 Issued in IL
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-3000
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 209019855 IL Primary

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone (847) 360-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191205002795 IL Practitioner - Nurse Practitioner 6103259148 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209019855ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Consultants of Northern Illinois S.C. CurrentSince Oct 1, 2023 Accepting new patients

Locations

1870 W Winchester Rd
Ste 247
Libertyville, IL 60048
Phone (847) 672-4940

1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000

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": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1720635170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINH",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209019855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.