Janze Marium Issac, ANP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209017708 Issued in IL

Practice address

1550 S Indiana Ave Ste 100
Chicago, IL 60605-4835

Phone

(845) 480-2862

NPI assigned

Feb 5, 2019

Last updated

May 7, 2019By the provider in NPPES

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

• Janze Marium Koshy Former name

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Metrorehab Inc.

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
  • NPI 1376676817
  Medicare reassignment NPD

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1912462870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S RIVER RD UNIT 404",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600168430",
            "telephone_number": "845-480-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S INDIANA AVE STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606054835",
            "telephone_number": "845-480-2862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 S River Rd Unit 404",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600168430",
            "country_code": "US",
            "telephone_number": "845-480-2862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISSAC",
        "first_name": "JANZE",
        "middle_name": "MARIUM",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209017708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANZE",
            "last_name": "KOSHY",
            "middle_name": "MARIUM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Naoum Issa
• Ola M Issa, PHARMD
• Ramzy Peter Issa
• Rochell Issa
• Tariq Ziad Issa
• Lydia Elizabeth Issac, M.D.
• Theodore Issen
• Anna Isyanov, M.D.
• Itac Medical Supply Company, LLC
• Italo D. Pieri, SC

• Gerontology Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.