Active NPI
Charity Polk
- Nurse Practitioner
- Matteson, IL
National Provider Identifier
1992639876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2026018821
- Practice address
- 49 Sundance Rd
Matteson, IL 60443-1284 - Phone
- (708) 215-4335
- NPI assigned
- Jun 9, 2026
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2026018821 | IL | Primary |
Addresses
Primary practice location
49 Sundance Rd
Matteson, IL 60443-1284
Mailing address
49 Sundance Rd
Matteson, IL 60443-1284
Phone (708) 215-4335
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780963200000",
"number": "1992639876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49 SUNDANCE RD",
"city": "MATTESON",
"state": "IL",
"postal_code": "604431284",
"telephone_number": "708-215-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 SUNDANCE RD",
"city": "MATTESON",
"state": "IL",
"postal_code": "604431284",
"telephone_number": "708-215-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "CHARITY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-09",
"last_updated": "2026-06-09",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "2026018821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matteson, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.