Individual provider Active NPI

Katherine Matics, DNP, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1841779733
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209017926 Issued in IL
Practice address
3256 W 24TH St
Chicago, IL 60623-3407
Phone
(872) 588-3540
NPI assigned
Aug 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209017926 IL Primary

Addresses

Primary practice location

3256 W 24TH St
Chicago, IL 60623-3407

Mailing address

3860 W Ogden Ave
Chicago, IL 60623-2460
Phone (872) 588-3000

Other identifiers 3

IdentifierTypeStateIssuer
209017926OtherILSTATE LICENSE
2018013646OtherILSPECIALTY BOARD
309013184OtherILCS LICENSE

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
I20180912000339 IL Practitioner - Nurse Practitioner 9335499342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawndale Christian Health CenterGroup PAC ID 2264336346, 124 clinicians

Practice addresses (Care Compare)

3860 W Ogden Ave
Chicago, IL 60623-2460
Phone (872) 588-3000

Hospital & facility affiliations

  • Mt Sinai Hospital Medical Center Hospital, Chicago, IL, CCN 140018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209017926ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center Current Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 8, 2018 Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 8, 2018 Accepting new patients

Locations

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

4696 Paysphere Cir
Chicago, IL 60674

3256 W 24th St
Chicago, IL 60623
Phone (773) 843-3000

Interoperability endpoints

  • Direct secure messaging: kmatics690923@direct.ochin.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1841779733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3256 W 24TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233407",
            "telephone_number": "872-588-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATICS",
        "first_name": "KATHERINE",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2023-03-07",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209017926",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALTY BOARD",
            "identifier": "2018013646",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS LICENSE",
            "identifier": "309013184",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.