Individual provider Active NPI

Kristine Ivy Pol Gumapas, MSN, AGACNP-BC, CCRN

  • Acute Care Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1740158690
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209027420 Issued in IL
Practice address
909 Davis St
Evanston, IL 60201-3683
Phone
(224) 487-4624
NPI assigned
Oct 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209027420 IL Primary

Addresses

Primary practice location

909 Davis St
Evanston, IL 60201-3683

Mailing address

1819 N Saint Louis Ave Apt 1RS
Chicago, IL 60647-2261
Phone (773) 512-3641

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)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209027420ILMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1740158690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 N SAINT LOUIS AVE APT 1RS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472261",
            "telephone_number": "773-512-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 DAVIS ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013683",
            "telephone_number": "224-487-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUMAPAS",
        "first_name": "KRISTINE IVY",
        "middle_name": "POL",
        "name_prefix": "Mrs.",
        "credential": "MSN, AGACNP-BC, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209027420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.