Individual provider Active NPI

Kate Lustbader

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1871382242
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
20903441904152272 Issued in IL
Practice address
9 W Walton St Apt 1902
Chicago, IL 60610-7331
Phone
(847) 284-4112
NPI assigned
May 2, 2025
Last updated
Aug 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 20903441904152272 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9 W Walton St Apt 1902
Chicago, IL 60610-7331

Mailing address

9 W Walton St Apt 1902
Chicago, IL 60610-7331
Phone (847) 284-4112

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

LicenseStateTypeSpecialty
20903441904152272ILMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1871382242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 W WALTON ST APT 1902",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107331",
            "telephone_number": "847-284-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 W WALTON ST APT 1902",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606107331",
            "telephone_number": "847-284-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTBADER",
        "first_name": "KATE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-02",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "20903441904152272",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.