Active NPI
Caroline Colsen Lois, PA-C
- Physician Assistant
- Chicago, IL
National Provider Identifier
1811371479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.006094
- Practice address
- 5841 S Maryland Ave
Chicago, IL 60637-1447 - Phone
- (773) 702-3329
- Fax
- (773) 834-8891
- NPI assigned
- Jul 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3573-23 | WI | |
| Physician Assistant | 363A00000X | 085.006094 | IL | Primary |
Addresses
Primary practice location
5841 S Maryland Ave
Chicago, IL 60637-1447
Mailing address
180 Harvester Dr Ste 110
Burr Ridge, IL 60527-6686
Phone (773) 702-1150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811371479 | Other | NPI |
Other names 1
- Caroline Anne Colsen
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
| License | State | Type | Specialty |
|---|---|---|---|
| 085.006094 | IL | MD | Physician Assistant |
| 3573-23 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Community Hospital Association | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1811371479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 HARVESTER DR STE 110",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605276686",
"telephone_number": "773-702-1150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5841 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371447",
"telephone_number": "773-702-3329",
"fax_number": "773-834-8891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOIS",
"first_name": "CAROLINE",
"middle_name": "COLSEN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3573-23",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.006094",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1811371479",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLINE",
"last_name": "COLSEN",
"middle_name": "ANNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.