Martha Jean Illies, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

173850-30 Issued in WI

Practice address

8496 Silverview CT
Lorton, VA 22079-4404

Phone

(414) 339-9124

NPI assigned

Sep 7, 2020

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

• Martha Jean Schroeder Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599436800000",
    "number": "1881208882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8496 SILVERVIEW CT",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794404",
            "telephone_number": "414-339-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8496 SILVERVIEW CT",
            "city": "LORTON",
            "state": "VA",
            "postal_code": "220794404",
            "telephone_number": "414-339-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLIES",
        "first_name": "MARTHA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2020-09-07",
        "certification_date": "2020-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "173850-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "SCHROEDER",
            "middle_name": "JEAN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Nurse in Lorton, VA
• Providers in Lorton, VA by specialty
• Registered Nurse in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2020; 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.