Individual provider Active NPI

Nelya Stesal, N.P

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1841408515
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209005900 Issued in IL
Practice address
9555 Gross Point Road
Skokie, IL 60076
Phone
(847) 679-3411
Fax
(847) 675-7450
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209005900 IL Primary

Addresses

Primary practice location

9555 Gross Point Road
Skokie, IL 60076

Mailing address

9555 Gross Point Road
Skokie, IL 60076
Phone (847) 679-3411

Other identifiers 2

IdentifierTypeStateIssuer
209005900OtherILSTATE LICENSE
363L00000XOtherILTAX CODE

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 Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209005900ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1841408515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 GROSS POINT ROAD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-679-3411",
            "fax_number": "847-675-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 GROSS POINT ROAD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "60076",
            "telephone_number": "847-679-3411",
            "fax_number": "847-675-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STESAL",
        "first_name": "NELYA",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209005900",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX CODE",
            "identifier": "363L00000X",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.