THERESA A LARSON – Psychiatric/Mental Health Nurse Practitioner, NPI 1942040472

THERESA A LARSON is a healthcare provider. based in Deerfield, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209.029761 (IL). The NPI Number for THERESA A LARSON is 1942040472

Main info

Female
3 Years Of Experience
Name
THERESA A LARSON
NPI
1942040472
Phone
(847) 236-9310
Address
440 LAKE COOK RD STE 2
Enumeration Date
31 May 2024
Last Update Date
31 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8888701775
Graduation Year
2023 (3 years ago)
PAC ID
8123544475
Group Practice PAC ID
0749418630
Professional Enrollment ID
I20250429002976
Address ID
IL601692040HO2500XRDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for THERESA A LARSON

  • 440 LAKE COOK RD STE 2

    DEERFIELD, IL 600155263

    Phone: (847) 236-9310

    Fax: (847) 236-9411

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $170.

Total Amount is formed as General ($170) + Research ($0) + Ownership ($0) = $170.

Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($77).

Total Amount

$170

General + Research + Ownership

Payments

7

Total payment records

General Amount

$170

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250429002976INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0749418630View full group profile
NameSpecialtyState
-IL
Marriage And Family TherapistWI
Clinical Social WorkerIL
Nurse PractitionerWI
Mental Health CounselorIA
Mental Health CounselorIL
-FL
Nurse PractitionerIL
Mental Health CounselorIA
Clinical Social WorkerIL

Reviews

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Frequently asked questions

What is the registry number for THERESA A LARSON?
The registry entry for THERESA A LARSON shows NPI 1942040472.
Should I treat THERESA A LARSON as an active provider?
Patients and plans typically see THERESA A LARSON as active in the national extract.
What services align with THERESA A LARSON's listing?
THERESA A LARSON's public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to THERESA A LARSON?
THERESA A LARSON is associated with Deerfield, Illinois in the same public data insurers reference.
Why is information missing for THERESA A LARSON?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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