Individual provider Active NPI

Jamie Walters

  • Nurse Practitioner
  • Oak Lawn, IL
National Provider Identifier
1104272962
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209014273 Issued in IL
Practice address
9401 S Kostner Ave
Heartland Care Partners
Oak Lawn, IL 60453-2697
Phone
(800) 427-1902
Fax
(419) 531-2664
NPI assigned
May 11, 2016
Last updated
May 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209014273 IL Primary

Addresses

Primary practice location

9401 S Kostner Ave
Heartland Care Partners
Oak Lawn, IL 60453-2697

Mailing address

333 N Summit St FL 7
HCR Manorcare Medical Services of Florida LLC
Toledo, OH 43604-1531
Phone (419) 252-6031

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
I20160609002452 IL Practitioner - Nurse Practitioner 8820388499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healogics Specialty Physicians of Illinois, LLCGroup PAC ID 4486877511, 14 clinicians

Practice addresses (Care Compare)

77 N Airlite St
Elgin, IL 60123-4912
Phone (847) 622-3407

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HCR Manorcare Medical Services of Florida LLC Nurse Practitioner CurrentSince Jun 13, 2016 Accepting new patients
Healogics Specialty Physicians of Illinois, LLC Nurse Practitioner CurrentSince Apr 30, 2023 Accepting new patients

Locations

77 N Airlite St
Elgin, IL 60123
Phone (847) 622-3407

600 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 325-9630

301 Madison St
Ste 310
Joliet, IL 60435
Phone (815) 773-7737

200 Martin Ave
Naperville, IL 60540
Phone (630) 355-4111

9401 S Kostner Ave
Oak Lawn, IL 60453
Phone (708) 423-6731

L2540
Columbus, OH 43260

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1104272962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST FL 7",
            "address_2": "HCR MANORCARE MEDICAL SERVICES OF FLORIDA LLC",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "419-252-6031",
            "fax_number": "800-564-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 S KOSTNER AVE",
            "address_2": "HEARTLAND CARE PARTNERS",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532697",
            "telephone_number": "800-427-1902",
            "fax_number": "419-531-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.