Individual provider Active NPI

Noel N. Kamal, APN

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1912300369
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012286 Issued in IL
Practice address
5668 E State St Ste 1000
Rockford, IL 61108-2464
Phone
(815) 229-7580
Fax
(815) 229-7585
NPI assigned
Sep 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041-1361221 IL
Family Nurse Practitioner 363LF0000X 209012286 IL Primary

Addresses

Primary practice location

5668 E State St Ste 1000
Rockford, IL 61108-2464

Mailing address

5668 E State St Ste 1000
Rockford, IL 61108-2464
Phone (815) 229-7580

Other identifiers 1

IdentifierTypeStateIssuer
041-1361221OtherILRN LICENSE

Other names 1

  • Noel N. Norup Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151105001188 IL Practitioner - Nurse Practitioner 1759691686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041-1361221ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 19, 2017 Accepting new patients

Locations

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

5668 E State St
Rockford, IL 61108
Phone (815) 229-7580

5668 E State St
Ste 1000
Rockford, IL 61108
Phone (815) 229-7580

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

3701 Doty Rd
Woodstock, IL 60098
Phone (815) 334-3170

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1912300369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST STE 1000",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-229-7580",
            "fax_number": "815-229-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST STE 1000",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-229-7580",
            "fax_number": "815-229-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMAL",
        "first_name": "NOEL",
        "middle_name": "N.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-1361221",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041-1361221",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NOEL",
            "last_name": "NORUP",
            "middle_name": "N.",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.