Active NPI
Brittani Evans, LPN
- Licensed Practical Nurse
- South Holland, IL
National Provider Identifier
1881290914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 043114202
- Practice address
- 58 E 158TH PL
South Holland, IL 60473-1401 - Phone
- (708) 913-4298
- NPI assigned
- Dec 4, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 043114202 | IL | Primary |
Addresses
Primary practice location
58 E 158TH PL
South Holland, IL 60473-1401
Mailing address
525 Grosvenor PL
Chicago Heights, IL 60411-1829
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
| License | State | Type | Specialty |
|---|---|---|---|
| 043114202 | IL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1881290914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 GROSVENOR PL",
"city": "CHICAGO HEIGHTS",
"state": "IL",
"postal_code": "604111829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58 E 158TH PL",
"city": "SOUTH HOLLAND",
"state": "IL",
"postal_code": "604731401",
"telephone_number": "708-913-4298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "BRITTANI",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-04",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IL",
"license": "043114202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.