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1013273374 NPI number — MARY PATRICIA KO APN NURSE PRACTITION

NPI Number: 1013273374
Health Care Provider/Practitioner: MARY PATRICIA KO APN NURSE PRACTITION

Information about “1013273374” NPI (MARY PATRICIA KO APN NURSE PRACTITION) exists in 1013273374 in HTML format HTML  |  1013273374 in plain Text format TXT  |  1013273374 in PDF (Portable Document Format) PDF  |  1013273374 in an XML format XML  formats.

NPI Number : 1013273374 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013273374",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KO",
    "FirstName": "MARY",
    "MiddleName": "PATRICIA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "APN NURSE PRACTITION",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BRAUNSCHWEIG",
    "OtherFirstName": "MARY",
    "OtherMiddleName": "PATRICIA",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "NURSE PRACTITIONER",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1333 BURR RIDGE PKWY",
    "SecondLineMailingAddress": "SUITE 200",
    "MailingAddressCityName": "BURR RIDGE",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60527",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-832-1775",
    "MailingAddressFaxNumber": "630-832-3078",
    "FirstLinePracticeLocationAddress": "3800 N. CALIFORNIA AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60618",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-478-4222",
    "PracticeLocationAddressFaxNumber": "773-478-7867",
    "EnumerationDate": "04/11/2012",
    "LastUpdateDate": "11/18/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LA2100X",
        "TaxonomyName": "Acute Care Nurse Practitioner",
        "LicenseNumber": "AP60270270",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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