Amy Lynn Staker, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209010035 Issued in IL

Practice address

100 Gore Rd
Morris, IL 60450-9466

Phone

(815) 364-8919

NPI assigned

Nov 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Telemedico Physicians Pulmonary SCGroup PAC ID 6608294400, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Telemedico Physicians Pulmonary SC

  • Pulmonary Disease Physician
  • Highland Park, IL
  • NPI 1972115384
  Medicare reassignment Care Compare group NPD
• Morris Hospital

  • General Practice Physician
  • Morris, IL
  • NPI 1558466268
  Medicare reassignment NPD
• Morris Hospital

  • Clinical Medical Laboratory
  • Morris, IL
  • NPI 1003916412
  NPD
• Morris Hospital

  • General Practice Physician
  • Channahon, IL
  • NPI 1275648511
  NPD
• Morris Hospital

  • Health Service Clinic/Center
  • Morris, IL
  • NPI 1376658658
  NPD
• Morris Hospital

  • General Acute Care Hospital
  • Morris, IL
  • NPI 1649370057
  NPD
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  NPD (past)

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1063756492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GORE RD",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604509466",
            "telephone_number": "815-364-8919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 E Division St",
            "address_purpose": "LOCATION",
            "city": "Diamond",
            "state": "IL",
            "postal_code": "604166050",
            "country_code": "US",
            "telephone_number": "815-634-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27240 W Saxony Dr",
            "address_purpose": "LOCATION",
            "city": "Channahon",
            "state": "IL",
            "postal_code": "604101416",
            "country_code": "US",
            "telephone_number": "815-521-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAKER",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "209.010035",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Solis, LCPC
• Southwest Diabetes Endocrinology Associates SC
• Southwest Hearing Solutions, PLLC
• Southwest Physical Therapy and Rehabiliation, LTD
• Austin J Spoon, NP
• Alicia Anne Stalker, LMFT
• Paige Stalker
• Sydnee E Stalker
• Kayla Stamm
• Jenna Steffen, ATC

• Family Nurse Practitioner in Morris, IL
• Providers in Morris, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.