Individual provider Active NPI

Catherine Shannon Dezynski, WHNP, CNM

  • Advanced Practice Midwife
  • Chicago, IL
National Provider Identifier
1932409489
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209071470 Issued in IL
Practice address
5215 N California Ave FL 7
Chicago, IL 60625-7014
Phone
(312) 666-3494
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209.008431 IL
Advanced Practice Midwife 367A00000X 209-017470 IL
Advanced Practice Midwife 367A00000X 209071470 IL Primary

Addresses

Primary practice location

5215 N California Ave FL 7
Chicago, IL 60625-7014

Mailing address

5215 N California Ave FL 7
Chicago, IL 60625-7014
Phone (312) 666-3494

Other identifiers 1

IdentifierTypeStateIssuer
F400448067OtherILMEDICARE

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209.008431ILMDWomen's Health Nurse Practitioner
209-017470ILMDAdvanced Practice Midwife
209071470ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Brown Health Center Past Accepting new patients

Organizations & group practices 1

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1932409489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "312-666-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "312-666-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZYNSKI",
        "first_name": "CATHERINE",
        "middle_name": "SHANNON",
        "credential": "WHNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209.008431",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209-017470",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209071470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400448067",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.