Individual provider Active NPI

Christina Mary Koehler

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1760123244
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209024380 Issued in IL
Practice address
535 N Michigan Ave Apt 411
Chicago, IL 60611-3825
Phone
(913) 219-6204
NPI assigned
Apr 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041429070 IL
Nurse Practitioner 363L00000X 209024380 IL Primary

Addresses

Primary practice location

535 N Michigan Ave Apt 411
Chicago, IL 60611-3825

Mailing address

535 N Michigan Ave Apt 411
Chicago, IL 60611-3825
Phone (913) 219-6204

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

State licenses

LicenseStateTypeSpecialty
041429070ILMDRegistered Nurse
209024380ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1760123244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 N MICHIGAN AVE APT 411",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113825",
            "telephone_number": "913-219-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N MICHIGAN AVE APT 411",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113825",
            "telephone_number": "913-219-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "CHRISTINA",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041429070",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209024380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.