MEDICARE: BEATA A KRUPA APN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	277001607	IL
2	363L00000X	Nurse Practitioner	277001607	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	209013911	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1619327061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATA A KRUPA APN-CNP

Provider Business Mailing Address
First Line	:	9977 WOODS DR
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-1057
Country	:	US
Telephone Number	:	224-364-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	9977 WOODS DR
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077
Country	:	US
Telephone Number	:	224-364-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	04/09/2026

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