Individual provider Active NPI

Karla Kennedy, APN

  • Occupational Health Nurse Practitioner
  • Tinley Park, IL
National Provider Identifier
1801985973
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Nurse PractitionerTaxonomy code 363LX0106X
Practice address
18210 La Grange Rd
Suite 111
Tinley Park, IL 60477-7722
Phone
(708) 478-3960
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X IL Primary

Addresses

Primary practice location

18210 La Grange Rd
Suite 111
Tinley Park, IL 60477-7722

Mailing address

3040 Bob O Link Rd
Flossmoor, IL 60422-1420
Phone (708) 478-3960

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
209004982ILMDOccupational Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801985973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 BOB O LINK RD",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221420",
            "telephone_number": "708-478-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18210 LA GRANGE RD",
            "address_2": "SUITE 111",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604777722",
            "telephone_number": "708-478-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "KARLA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.