Individual provider Active NPI

Catherine Mary Goodale, NP

  • Acute Care Nurse Practitioner
  • Waukegan, IL
National Provider Identifier
1790938546
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209.007313 Issued in IL
Practice address
1324 N Sheridan Rd
Waukegan, IL 60085-2161
Phone
(847) 360-3000
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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 209.007313 IL Primary

Addresses

Primary practice location

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Mailing address

1155 Sumner Cir
Gurnee, IL 60031-4022
Phone (847) 244-4671

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
I20100628000901 IL Practitioner - Nurse Practitioner 8022149566 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.007313ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
App of Illinois Ed PLLC CurrentSince May 1, 2020 Accepting new patients
Oncology Hematology Associates of Northern Illinois, LTD CurrentSince Jan 24, 2010 Accepting new patients
Waukegan Clinic Corp Current Accepting new patients

Locations

200 S Greenleaf St
Ste A
Gurnee, IL 60031
Phone (847) 244-5660

200 S Greenleaf St
Ste L
Gurnee, IL 60031
Phone (847) 360-7888

1025 Red Oak Ln
Ste 280
Lindenhurst, IL 60046
Phone (847) 245-4747

1025 Red Oak Ln
Ste 120
Lindenhurst, IL 60046
Phone (847) 245-4601

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000

Interoperability endpoints

  • Direct secure messaging: catherine.goodale.1@2069.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1790938546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 SUMNER CIR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314022",
            "telephone_number": "847-244-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODALE",
        "first_name": "CATHERINE",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.007313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.