Active NPI
Nichole Cavanaugh, NP-C
- Family Nurse Practitioner
- Joliet, IL
National Provider Identifier
1982006458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.011988
- Practice address
- 333 Madison St
Joliet, IL 60435-8200 - Phone
- (815) 725-7133
- Fax
- (815) 773-7808
- NPI assigned
- Sep 16, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.361777 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209.011988 | IL | Primary |
Addresses
Primary practice location
333 Madison St
Joliet, IL 60435-8200
Mailing address
333 Madison St
Joliet, IL 60435-8200
Phone (815) 725-7133
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.361777 | IL | MD | Registered Nurse |
| 209.011988 | IL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576540800000",
"number": "1982006458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 MADISON ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358200",
"telephone_number": "815-725-7133",
"fax_number": "815-773-7808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 MADISON ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358200",
"telephone_number": "815-725-7133",
"fax_number": "815-773-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH",
"first_name": "NICHOLE",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2019-12-17",
"certification_date": "2019-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.361777",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.011988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
- Madison Catarello, BS, RN, MSN
- Catholic Charities of the Diocese of Joliet
- Catholic Charities of the Diocese of Joliet
- Catholic Charities, Diocese of Joliet
- Katelyn Marie Cattell
- Mary Rose Cavitt, DDS
- CCB Dental Associates PC
- Center for Disability Services
- Center for Family Services
- Center for Neuropsychiatric Development
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.