NPIMap

Organization Active NPI

Northwestern Memorial Healthcare

  • Urgent Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1942690672
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
209012197 Issued in IL
Legal business name
NORTHWESTERN MEMORIAL HEALTHCARE
Practice address
1030 N Wolcott Ave
Chicago, IL 60622-5986
Phone
(847) 471-3513
NPI assigned
Feb 3, 2015
Last updated
Feb 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Ms. Kelly Jo Nelson, BSN, MSN, FNP
Title
Nurse Practitoner
Phone
(847) 471-3513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 209012197 IL Primary

Addresses

Primary practice location

1030 N Wolcott Ave
Chicago, IL 60622-5986

Mailing address

1030 N Wolcott Ave
Chicago, IL 60622-5986
Phone (847) 471-3513

National Provider Directory

National Provider Directory
Tax ID family
Norwestern Memorial Hospital20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1942690672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 N WOLCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225986",
            "telephone_number": "847-471-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 N WOLCOTT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225986",
            "telephone_number": "847-471-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEMORIAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "NURSE PRACTITONER",
        "authorized_official_telephone_number": "847-471-3513",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN, MSN, FNP"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "IL",
            "license": "209012197",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 3, 2015; 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.