Individual provider Active NPI

Agnieszka Heleniak, FNP-BC

  • Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1033892260
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.024692 Issued in IL
Practice address
1000 Central St Ste 880
Evanston, IL 60201-1780
Phone
(847) 570-2570
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.024692 IL Primary

Addresses

Primary practice location

1000 Central St Ste 880
Evanston, IL 60201-1780

Mailing address

2180 Pfingsten Rd Ste 2000
Glenview, IL 60026-1339

Other practice location 1

2180 Pfingsten Rd Ste 2000
Glenview, IL 60026-1339
Phone (847) 570-2570

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
I20240909000837 IL Practitioner - Nurse Practitioner 3173063914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1000 Central St
Evanston, IL 60201-1780

2100 Pfingsten Rd
Glenview, IL 60026-1301

2650 Ridge Ave
Evanston, IL 60201-1700

920 Milwaukee Ave
Lincolnshire, IL 60069-3839
Phone (847) 866-7846

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.024692ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 27, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Jul 29, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

1000 Central St
Evanston, IL 60201
Phone (847) 570-1000

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1000 Central St
Ste 880
Evanston, IL 60201
Phone (847) 570-2825

2180 Pfingsten Rd
Ste 2000
Glenview, IL 60026

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1033892260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 PFINGSTEN RD STE 2000",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600261339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CENTRAL ST STE 880",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011780",
            "telephone_number": "847-570-2570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 Pfingsten Rd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261339",
            "country_code": "US",
            "telephone_number": "847-570-2570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELENIAK",
        "first_name": "AGNIESZKA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.024692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.