Individual provider Active NPI

Galina Shvayetskaya, APRN

  • Family Nurse Practitioner
  • Libertyville, IL
National Provider Identifier
1164017034
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.022868 Issued in IL
Practice address
755 S Milwaukee Ave
Libertyville, IL 60048-3253
Phone
(242) 364-3202
NPI assigned
Mar 3, 2021
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.022868 IL Primary

Addresses

Primary practice location

755 S Milwaukee Ave
Libertyville, IL 60048-3253

Mailing address

755 S Milwaukee Ave
Libertyville, IL 60048-3253
Phone (242) 364-3202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.022868ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integra Healthcare SC Single Specialty CurrentSince Apr 1, 2021 Accepting new patients
A Podolskiy MD SC Single Specialty CurrentSince Apr 1, 2021 Accepting new patients

Locations

755 S Milwaukee Ave
Ste 164
Libertyville, IL 60048
Phone (847) 247-0187

2504 Washington St
Waukegan, IL 60085
Phone (847) 336-2288

2534 Elim Ave
Zion, IL 60099
Phone (847) 328-6503

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.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1164017034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483253",
            "telephone_number": "242-364-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483253",
            "telephone_number": "242-364-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHVAYETSKAYA",
        "first_name": "GALINA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.