Mark C Chua, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95008812 Issued in CA

Practice address

4632 Church St Ste 101
Skokie, IL 60076-1545

Phone

(847) 768-1050

Fax

(847) 768-1064

NPI assigned

Sep 17, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Admire Home Health Care Agency, Inc.

  • Home Health Agency
  • Skokie, IL
  • NPI 1518972256
  NPD Authorized official

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1891345294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 CHURCH ST STE 101",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761545",
            "telephone_number": "847-768-1050",
            "fax_number": "847-768-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 CHURCH ST STE 101",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761545",
            "telephone_number": "847-768-1050",
            "fax_number": "847-768-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUA",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTERED NURSING",
            "identifier": "95008812",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "markxrist@sbcglobal.net",
            "affiliation": "N",
            "address_1": "4632 Church St Ste 101",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600761545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Helen Choi
• Jane Choi, FNP
• Chris H Chon, MD
• Magdalena M Chowaniec, PTA
• Agnieszka Chruszczyk, DDS
• Holly Chuang
• Elizabeth K Chung, M.D.
• Susie Chung, D.D.S.
• Yoo Mi Chung, D.P.T
• Church St Pharm Inc

• Family Nurse Practitioner in Skokie, IL
• Providers in Skokie, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.