Individual provider Active NPI

Katherine Marie Larsen, NP-C

  • Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1760970073
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017504 Issued in IL
Practice address
259 E Erie St FL 17
Chicago, IL 60611-2987
Phone
(312) 926-6000
Fax
(312) 926-6433
NPI assigned
Apr 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209017504 IL Primary

Addresses

Primary practice location

259 E Erie St FL 17
Chicago, IL 60611-2987

Mailing address

259 E Erie St FL 17
Chicago, IL 60611-2987
Phone (312) 926-6000

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
I20181105000515 IL Practitioner - Nurse Practitioner 1355694654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2635 Church Rd
Suite 101
Aurora, IL 60502-8943
Phone (630) 315-6900

2900 Foxfield Rd
Suite 100
St Charles, IL 60174-5799
Phone (630) 377-6500

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

7 Blanchard Cir
Wheaton, IL 60189-2038

820 Route 59
Barlett, IL 60103-1694
Phone (630) 213-9600

820 S Il Route 59
Suite 320
Bartlett, IL 60103-1694
Phone (630) 225-2663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Sep 15, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 15, 2018 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

2635 Church Rd
Ste 101
Aurora, IL 60502
Phone (630) 315-6900

231 S Gary Ave
Ste 100
Bloomingdale, IL 60108
Phone (630) 893-9600

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

1333 W Belmont Ave
Ste 100
Chicago, IL 60657
Phone (312) 693-2273

4445 W Irving Park Rd
Ste 110
Chicago, IL 60641
Phone (312) 921-0417

259 E Erie St
Fl 17
Chicago, IL 60611
Phone (312) 926-4566

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

171 N Aberdeen St
Ste 100
Chicago, IL 60607
Phone (312) 694-2273

1630 Sherman Ave
Ste 130
Evanston, IL 60201
Phone (224) 271-4400

885 Roosevelt Rd
Ste 100
Glen Ellyn, IL 60137
Phone (630) 384-6200

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2900 Foxfield Rd
Ste 100
St Charles, IL 60174
Phone (630) 377-6500

7 Blanchard Cir
Ste 102
Wheaton, IL 60189
Phone (630) 510-9009

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1760970073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000",
            "fax_number": "312-926-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "KATHERINE",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.