Individual provider Active NPI

Anne Marie Elizabeth Drahos, MSN, APN, CPNP

  • Pediatric Nurse Practitioner
  • Arlington Heights, IL
National Provider Identifier
1083934442
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209008051 Issued in IL
Practice address
3040 W Salt Creek LN
Arlington Heights, IL 60005-1069
Phone
(847) 483-7043
NPI assigned
Jun 8, 2010
Last updated
Jun 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209008051 IL Primary

Addresses

Primary practice location

3040 W Salt Creek LN
Arlington Heights, IL 60005-1069

Mailing address

701 S Carpenter St Unit D
Chicago, IL 60607-3471
Phone (312) 243-2559

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
I20120127000983 IL Practitioner - Nurse Practitioner 2365609682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209008051ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC CurrentSince Oct 2, 2011 Accepting new patients

Locations

3040 W Salt Creek Ln
Arlington Heights, IL 60005
Phone (847) 618-3481

1555 N Barrington Rd
Bldg 1
Hoffman Estates, IL 60169
Phone (224) 299-4222

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1083934442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S CARPENTER ST UNIT D",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073471",
            "telephone_number": "312-243-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 W SALT CREEK LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051069",
            "telephone_number": "847-483-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAHOS",
        "first_name": "ANNE MARIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MSN, APN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209008051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.