Individual provider Active NPI

Marilynn Maida, APN

  • Clinical Nurse Specialist
  • Elk Grove Village, IL
National Provider Identifier
1760856074
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
209005808 Issued in IL
Practice address
800 Biesterfield Rd
Elk Grove Village, IL 60007
Phone
(847) 981-3630
NPI assigned
Nov 24, 2015
Last updated
Mar 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 209005808 IL Primary
Neurological Surgery Physician 207T00000X 309008970 IL

Addresses

Primary practice location

800 Biesterfield Rd
Elk Grove Village, IL 60007

Mailing address

800 Biesterfield Rd
Elk Grove Village, IL 60007-3397

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address marilynn.maida.1@380.direct.athenahealth.com

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

State licenses

LicenseStateTypeSpecialty
309008970ILMDNeurological Surgery Physician

Interoperability endpoints

  • Direct secure messaging: marilynn.maida.1@380.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1760856074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "60007",
            "telephone_number": "847-981-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIDA",
        "first_name": "MARILYNN",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209005808",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "309008970",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marilynn.maida.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.