Individual provider Active NPI

Amy Kathleen Rourke Wasserman, APN, CNM

  • Advanced Practice Midwife
  • Highland Park, IL
National Provider Identifier
1770849986
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
277.002578 Issued in IL
Practice address
3073 Summit Ave
Highland Park, IL 60035-1157
Phone
(773) 484-0524
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.027714 IL
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X 277.002578 IL Primary

Addresses

Primary practice location

3073 Summit Ave
Highland Park, IL 60035-1157

Mailing address

3073 Summit Ave
Highland Park, IL 60035-1157
Phone (773) 484-0524

Other practice location 1

1901 N Clybourn Ave Ste 304
Chicago, IL 60614-6808
Phone (773) 484-0524

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209.027714ILMDPsychiatric/Mental Health Nurse Practitioner
277.002578ILMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1770849986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 SUMMIT AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600351157",
            "telephone_number": "773-484-0524",
            "fax_number": "312-820-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 SUMMIT AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600351157",
            "telephone_number": "773-484-0524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 N Clybourn Ave Ste 304",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606146808",
            "country_code": "US",
            "telephone_number": "773-484-0524",
            "fax_number": "312-820-3557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "AMY",
        "middle_name": "KATHLEEN ROURKE",
        "name_prefix": "Mrs.",
        "credential": "APN, CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.027714",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "277.002578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; 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.