Individual provider Active NPI

Laura Ann Rogge

  • Nurse Practitioner
  • Wilmette, IL
National Provider Identifier
1952171019
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209028955 Issued in IL
Practice address
1010 Hibbard Rd
Wilmette, IL 60091-1124
Phone
(847) 903-5785
NPI assigned
Jan 8, 2024
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209028955 IL Primary

Addresses

Primary practice location

1010 Hibbard Rd
Wilmette, IL 60091-1124

Mailing address

134 Michael LN
New Lenox, IL 60451-1140
Phone (708) 469-9945

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
I20240131002940 IL Practitioner - Nurse Practitioner 0042663593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

2451 W Touhy Ave
Chicago, IL 60645-3309
Phone (312) 593-5599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209028955ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Healthcare LLC Nurse Practitioner CurrentSince Dec 18, 2023 Accepting new patients

Locations

422 E 4th St S
Arcola, IL 61910
Phone (217) 268-3022

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

14255 Cicero Ave
Crestwood, IL 60418
Phone (708) 371-0400

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

200 Martin Ave
Naperville, IL 60540
Phone (630) 236-8018

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

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1952171019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 MICHAEL LN",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511140",
            "telephone_number": "708-469-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 HIBBARD RD",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911124",
            "telephone_number": "847-903-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGGE",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209028955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.