Active NPI
Evelyn Addie Edmond
- Registered Nurse
- Chicago Heights, IL
National Provider Identifier
1821863523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041-212533
- Practice address
- 1010 Dixie Hwy
State of Illinois Dept. of Human Services
Chicago Heights, IL 60411 - Phone
- (708) 709-3316
- NPI assigned
- Nov 22, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041-212533 | IL | Primary |
Addresses
Primary practice location
1010 Dixie Hwy
State of Illinois Dept. of Human Services
Chicago Heights, IL 60411
Mailing address
1010 Dixie Hwy
State of Illinois Dept. of Human Services
Chicago Heights, IL 60411
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 |
|---|---|---|---|
| 041-212533 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700611200000",
"number": "1821863523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 DIXIE HWY",
"address_2": "STATE OF ILLINOIS DEPT. OF HUMAN SERVICES",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "60411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 DIXIE HWY",
"address_2": "STATE OF ILLINOIS DEPT. OF HUMAN SERVICES",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "60411",
"telephone_number": "708-709-3316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMOND",
"first_name": "EVELYN",
"middle_name": "ADDIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-22",
"last_updated": "2023-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041-212533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.