Active NPI
Kristen McCourt
- Psychiatric/Mental Health Nurse Practitioner
- Forest Park, IL
National Provider Identifier
1932726569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209.021532
- Practice address
- 8311 Roosevelt Rd
Forest Park, IL 60130-2500 - Phone
- (708) 771-7000
- NPI assigned
- Jun 30, 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209.021532 | IL | Primary |
Addresses
Primary practice location
8311 Roosevelt Rd
Forest Park, IL 60130-2500
Mailing address
7402 Devereux Rd
Downers Grove, IL 60516-3741
Phone (248) 672-4448
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.021532 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1932726569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7402 DEVEREUX RD",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605163741",
"telephone_number": "248-672-4448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8311 ROOSEVELT RD",
"city": "FOREST PARK",
"state": "IL",
"postal_code": "601302500",
"telephone_number": "708-771-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOURT",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-30",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209.021532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.