Individual provider Active NPI

Antony V Antony, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lockport, IL
National Provider Identifier
1093470692
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.024313 Issued in IL
Practice address
16540 S Nottingham CT
Lockport, IL 60441-6289
Phone
(630) 363-6785
NPI assigned
Nov 8, 2021
Last updated
Nov 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.024313 IL Primary

Addresses

Primary practice location

16540 S Nottingham CT
Lockport, IL 60441-6289

Mailing address

16540 S Nottingham CT
Lockport, IL 60441-6289
Phone (630) 363-6785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209.024313ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bassi Mental Health PA CurrentSince Jun 9, 2024 Accepting new patients

Locations

1820 State Road 13 N
Ste 11926
St Johns, FL 32259
Phone (888) 730-5220

1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334

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": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1093470692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16540 S NOTTINGHAM CT",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604416289",
            "telephone_number": "630-363-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16540 S NOTTINGHAM CT",
            "city": "LOCKPORT",
            "state": "IL",
            "postal_code": "604416289",
            "telephone_number": "630-363-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONY",
        "first_name": "ANTONY",
        "middle_name": "V",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.024313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.