Individual provider Active NPI

Kristine Mulingbayan, NP-C

  • Adult Health Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1124457254
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209.010878 Issued in IL
Practice address
4711 Golf Rd
Suite 807
Skokie, IL 60076-1224
Phone
(847) 677-7502
Fax
(847) 677-7516
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209.010878 IL Primary

Addresses

Primary practice location

4711 Golf Rd
Suite 807
Skokie, IL 60076-1224

Mailing address

4711 Golf Rd
Suite 807
Skokie, IL 60076-1224
Phone (847) 677-7502

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
I20250722000385 IL Practitioner - Nurse Practitioner 8224544762 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.010878ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Immediate Care LLC CurrentSince May 1, 2025 Accepting new patients
Head & Neck Cosmetic Surgery Associates LLC Past Accepting new patients

Locations

1601 W Division St
Chicago, IL 60622
Phone (773) 227-3669

1645 W School St
Ste A
Chicago, IL 60657
Phone (773) 227-3669

7262 Solutions Ctr
Chicago, IL 60677

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEHBA/Endpoint/HAEHBA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1124457254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 807",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-677-7502",
            "fax_number": "847-677-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD",
            "address_2": "SUITE 807",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761224",
            "telephone_number": "847-677-7502",
            "fax_number": "847-677-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULINGBAYAN",
        "first_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.010878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.