Kathleen S Antunovich, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209-001181 Issued in IL

Practice address

977 N Oaklawn Ave
Suite 104
Elmhurst, IL 60126-1045

Phone

(630) 832-1775

Fax

(630) 832-3078

NPI assigned

Dec 4, 2013

Last updated

Dec 4, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathy S Antunovich Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946

  Adult Health

  NPD (past)

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1861823692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 N OAKLAWN AVE",
            "address_2": "SUITE 104",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261045",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 N OAKLAWN AVE",
            "address_2": "SUITE 104",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261045",
            "telephone_number": "630-832-1775",
            "fax_number": "630-832-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTUNOVICH",
        "first_name": "KATHLEEN",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-04",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209-001181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "ANTUNOVICH",
            "middle_name": "S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Georgia D. Andrianopoulos, PHD LCPC
• Ankle N Foot Centers LLC
• Alexandra Annen
• Diana Susan Anton, APN
• Dominic Joseph Antonacci, MD
• Austin Aper
• Apollo Diagnostics Inc
• Adam Apostolovich, L.C.S.W.
• Saera Arain Saleem, DPM
• Kavin Arasi Arasar, M.D.

• Adult Health Nurse Practitioner in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; 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.