Individual provider Active NPI

Angelika Fiedorowicz, APRN

  • Family Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1073274650
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024353 Issued in IL
Practice address
2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone
(331) 204-5896
NPI assigned
Jan 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209024353 IL Primary

Addresses

Primary practice location

2955 W 95TH St
Evergreen Park, IL 60805-2409

Mailing address

2955 W 95TH St
Evergreen Park, IL 60805-2409
Phone (708) 369-5260

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
I20220907001930 IL Practitioner - Nurse Practitioner 8527442771 Reassigns benefits to 3 organizations

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
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

5300 S Long Ave
Chicago, IL 60638-2918
Phone (312) 300-7400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209024353ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Aug 1, 2022 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince Feb 26, 2024 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Aug 1, 2022 Accepting new patients

Locations

2070 N State Route 50
Ste 500
Bourbonnais, IL 60914
Phone (779) 236-4094

800 W Fulton Market
Fl 12
Chicago, IL 60607

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

515 Belt Line Rd
Collinsville, IL 62234
Phone (618) 344-7882

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

9701 W Higgins Rd
Ste 270
Rosemont, IL 60018
Phone (847) 653-0130

534 Randall Rd
South Elgin, IL 60177

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 4

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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1073274650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "708-369-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 W 95TH ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052409",
            "telephone_number": "331-204-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDOROWICZ",
        "first_name": "ANGELIKA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.