Amy Nicole Bonfiglio, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Zion, IL
NPI 1083085013 · NPPES record last updated Jan 7, 2025
Key facts
- NPI
- 1083085013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209013435 (IL)
- Practice address
- 2520 Elisha Avenue
Zion, IL 60099 - Phone
- (800) 322-9183
- Fax
- (847) 526-2017
- NPI assigned
- Oct 16, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160622001095 | IL | Practitioner - Nurse Practitioner | 2567753544 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Group of Illinois PLLC | Current |
Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current |
Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current |
Accepting new patients | |
| Waukegan Clinic Corp | Past | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358
2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183
Interoperability endpoints
- https://api.platform.athenahealth.com/14507/brand/1/csg/1/fhir/r4
- abonfiglio169037@cityofhope.direct-ci.com
- https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209013435 | IL | Yes |
Addresses
Primary practice location
2520 Elisha Avenue
Zion, IL 60099
Mailing address
2361 Paysphere Circle
Chicago, IL 60067
Phone (800) 322-9183
Other providers in Zion, IL
- Neel Gopal Bhalala
- Hermineh Biramian
- Harold John Birky
- Blossom & Sprout Wellness, PLLC
- Alexandra Boltz
- Ninfa Bontes
- Shaun Boyes
- Dayle M Boyle
- Nicole Ann Breiling-Smith
- Brent C Paxton P C
All providers in Zion, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.