Nicole S. Nettgen, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

209-003302 Issued in IL

Practice address

375 N Wall St
Suite P630
Kankakee, IL 60901-3483

Phone

(815) 933-4510

Fax

(815) 933-4259

NPI assigned

Mar 13, 2007

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

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Anthony Health AffiliatesGroup PAC ID 1254321474, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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

• Saint Anthony Health Affiliates

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1881086064
  Medicare reassignment Care Compare group
• Pathology Services Illinois, LTD

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
  • NPI 1013012939
  NPD
• Saint Anthony Health Affiliates

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1295757771

  Advanced Practice Midwife

  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1730212309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 LARK LN",
            "city": "SHOREWOOD",
            "state": "IL",
            "postal_code": "604049649",
            "telephone_number": "815-933-4510",
            "fax_number": "815-933-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N WALL ST",
            "address_2": "SUITE P630",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013483",
            "telephone_number": "815-933-4510",
            "fax_number": "815-933-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTGEN",
        "first_name": "NICOLE",
        "middle_name": "S.",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209-003302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Nathan Musk
• Nadeem Ansari, M.D.,S.C.
• Mukhtar Hussain Naqvi, DO
• Nashib Hashmi MD PC (Kidney Center of Kankakee)
• Brianna C Neal, APRN
• Neurology LTD
• Victor Nevarez Sr., CADC
• New Life Pentecostal Medical Clinic for the Uninsured Inc (New Life Pentecostal Medical Clinic for the Uninsured)
• Cheryl Newberry
• Newsome Rehabilitation Center

• Advanced Practice Midwife in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Advanced Practice Midwife in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.