MS. LATEISHA NICOLE FORT APN NPI 1275024523

NPI Information

NPI: 1275024523
Provider Name: MS. LATEISHA NICOLE FORT, APN
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
3551 HIGHLAND AVE STE 200A
DOWNERS GROVE, IL
ZIP 60515
Phone: (844) 376-3876
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MS. Lateisha Nicole Fort, APN is an acute care nurse practitioner in Downers Grove, IL with 7 years of experience. MS. Lateisha Nicole Fort, APN NPI is 1275024523. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3551 HIGHLAND AVE STE 200A
DOWNERS GROVE, IL
ZIP 60515-100
Phone: (844) 376-3876
Fax: (630) 929-0633

The NPI 1275024523 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/22/2018 and was last updated on 2/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	209017544	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	921750533	OTHER	ILLINOIS	PRIMARY CARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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