Individual provider Active NPI

Shailly Brahmakshatriya, FNP

  • Nurse Practitioner
  • Libertyville, IL
National Provider Identifier
1184424376
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209-031605 Issued in IL
Practice address
900 Technology Way Ste 120
Libertyville, IL 60048-5364
Phone
(708) 364-0269
NPI assigned
Mar 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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 209-031605 IL Primary

Addresses

Primary practice location

900 Technology Way Ste 120
Libertyville, IL 60048-5364

Mailing address

900 Technology Way Ste 120
Libertyville, IL 60048-5364
Phone (708) 364-0269

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
I20250910003901 IL Practitioner - Nurse Practitioner 1153824776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sigma Health PCGroup PAC ID 2961305693, 22 clinicians

Practice addresses (Care Compare)

900 Technology Way
Suite 120
Libertyville, IL 60048-5364
Phone (708) 364-0261

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-031605ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sigma Health PC CurrentSince Jun 20, 2025 Accepting new patients

Locations

900 Technology Way
Ste 120
Libertyville, IL 60048
Phone (708) 364-0269

10640 165th St
Orland Park, IL 60467

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1184424376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TECHNOLOGY WAY STE 120",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485364",
            "telephone_number": "708-364-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TECHNOLOGY WAY STE 120",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485364",
            "telephone_number": "708-364-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHMAKSHATRIYA",
        "first_name": "SHAILLY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209-031605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.