Jolyn Marie Kowallis, APN,NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209008090 Issued in IL

Practice address

1555 Barrington Rd
Doctors Building #3-Suite 1200
Hoffman Estates, IL 60169-1019

Phone

(847) 885-4100

Fax

(847) 885-4199

NPI assigned

Apr 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jolyn Marie Berg Former name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment NPD
• Paragon Clinical LLC

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1114139946
  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Alexian Brothers Medical Care Group NFP

  • Pulmonary Disease Physician
  • Elk Grove Village, IL
  • NPI 1518420413
  NPD (past)
• Paragon Clinical Midwest, LLC

  • Nurse Practitioner
  • Merrillville, IN
  • NPI 1619335700
  NPD (past)

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1194042283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD",
            "address_2": "DOCTORS BUILDING #3-SUITE 1200",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691019",
            "telephone_number": "847-885-4100",
            "fax_number": "847-885-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BARRINGTON RD",
            "address_2": "DOCTORS BUILDING #3-SUITE 1200",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691019",
            "telephone_number": "847-885-4100",
            "fax_number": "847-885-4199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Biesterfield Rd Ste 510",
            "address_purpose": "LOCATION",
            "city": "Elk Grove Village",
            "state": "IL",
            "postal_code": "600073367",
            "country_code": "US",
            "telephone_number": "847-981-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALLIS",
        "first_name": "JOLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APN,NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209008090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sublung@380.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd Ste 510",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOLYN",
            "last_name": "BERG",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "APN,NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nagabhushanam Koneru, M.D.
• Katherine Janine Konstant
• Alexandra Koroleva-Regalado, M. ED.
• George Kotsakis, D.M.D.
• Taliya Kottai, M.A., CCC, SLP
• Allison Ann Kowieski, MA, LPC
• Betul Koyuncu, OT
• Steven C Kraemer, DDS
• Meena Ramalingam Krishna, M.D
• Djamilia Emilbekovna Kryukov, M.D.

• Nurse Practitioner in Hoffman Estates, IL
• Providers in Hoffman Estates, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.