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1740516541 NPI number — HEIDI J BECKSTROM APN

NPI Number: 1740516541
Health Care Provider/Practitioner: HEIDI J BECKSTROM APN

Information about “1740516541” NPI (HEIDI J BECKSTROM APN) exists in 1740516541 in HTML format HTML  |  1740516541 in plain Text format TXT  |  1740516541 in PDF (Portable Document Format) PDF  |  1740516541 in an XML format XML  formats.

NPI Number : 1740516541 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740516541",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BECKSTROM",
    "FirstName": "HEIDI",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5777 DEPT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CAROL STREAM",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60122-5777",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "312-695-9797",
    "MailingAddressFaxNumber": "630-933-2740",
    "FirstLinePracticeLocationAddress": "1850 GATEWAY DR STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SYCAMORE",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60178-3192",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "815-217-3252",
    "PracticeLocationAddressFaxNumber": "815-756-4941",
    "EnumerationDate": "10/29/2009",
    "LastUpdateDate": "08/30/2024",
    "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": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "209007813",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "364SE0003X",
          "TaxonomyName": "Emergency Clinical Nurse Specialist",
          "LicenseNumber": "209007813",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "209007813",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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