Active NPI
Cheryl Ann Olofsson, RN
- Diabetes Educator Registered Nurse
- Kankakee, IL
National Provider Identifier
1851683528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diabetes Educator Registered Nurse
- License
- 041240910
- Practice address
- 400 N Wall St
Suite 510
Kankakee, IL 60901-2940 - Phone
- (815) 932-5725
- Fax
- (815) 932-5872
- NPI assigned
- May 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | 041240910 | IL | Primary |
Addresses
Primary practice location
400 N Wall St
Suite 510
Kankakee, IL 60901-2940
Mailing address
400 N Wall Street
Suite 510
Kankakee, IL 60901
Phone (815) 932-5725
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041240910 | IL | MD | Diabetes Educator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305158400000",
"number": "1851683528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N WALL STREET",
"address_2": "SUITE 510",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "60901",
"telephone_number": "815-932-5725",
"fax_number": "815-932-5872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N WALL ST",
"address_2": "SUITE 510",
"city": "KANKAKEE",
"state": "IL",
"postal_code": "609012940",
"telephone_number": "815-932-5725",
"fax_number": "815-932-5872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLOFSSON",
"first_name": "CHERYL",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-12",
"last_updated": "2011-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "IL",
"license": "041240910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kankakee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.