Individual provider Active NPI

Linna Mukamusoni, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1023720133
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209026433 Issued in IL
Practice address
9718 S Halsted St
Chicago, IL 60628-1007
Phone
(773) 233-4100
Fax
(773) 344-3158
NPI assigned
Dec 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026433 IL Primary

Addresses

Primary practice location

9718 S Halsted St
Chicago, IL 60628-1007

Mailing address

9718 S Halsted St
Chicago, IL 60628-1007
Phone (773) 233-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231122002693 IL Practitioner - Nurse Practitioner 7719335181 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
KND Development 59 LLCGroup PAC ID 3678602802, 176 clinicians

Practice addresses (Care Compare)

2544 W Montrose Ave
Chicago, IL 60618-1537
Phone (773) 267-2622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209026433ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Community Health Center Current Accepting new patients
KND Development 59, LLC CurrentSince Dec 12, 2023 Accepting new patients
KND Development 59 LLC CurrentSince Dec 12, 2023 Accepting new patients
Christian Community Health Center CurrentSince Sep 23, 2023 Accepting new patients
Christian Community Health Center CurrentSince Sep 23, 2023 Accepting new patients
KND Development 59 LLC Current Accepting new patients

Locations

364 Torrence Ave
Calumet City, IL 60409
Phone (708) 868-9457

6130 N Sheridan Rd
Chicago, IL 60660
Phone (773) 381-1222

9718 S Halsted St
Chicago, IL 60628
Phone (773) 233-4100

2544 W Montrose Ave
Chicago, IL 60618
Phone (773) 267-2622

901 E Sibley Blvd
South Holland, IL 60473
Phone (708) 333-8020

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1023720133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281007",
            "telephone_number": "773-233-4100",
            "fax_number": "773-344-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9718 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281007",
            "telephone_number": "773-233-4100",
            "fax_number": "773-344-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKAMUSONI",
        "first_name": "LINNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-20",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209026433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.