Iyeokan Emmanuela Ativie, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209022852 Issued in IL

Practice address

2050 Nelson Rd
New Lenox, IL 60451-8537

Phone

(815) 463-5281

NPI assigned

Mar 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, OH, MI, MN4 enrollments

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 4

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL, MI, MN

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1205421815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S KING DR APT 1801",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163330",
            "telephone_number": "773-372-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 NELSON RD",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604518537",
            "telephone_number": "815-463-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIVIE",
        "first_name": "IYEOKAN",
        "middle_name": "EMMANUELA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Augustine A Atem
• Athletic and Therapeutic Institute of Bourbonnais, LLC
• Athletic and Therapeutic Institute of Naperville, LLC (ATI Physical Therapy)
• Athletic and Therapeutic Institute of Naperville, LLC (ATI Physical Therapy)
• Athletico LTD (Athletico Sports Medicine and Physical Therapy)
• Laura Atkinson, FNP-C
• Firas Aubeid, M.D.
• Steven W Augustus, MA LCPC
• Gina Marie Austin, MS
• Juan Avila, PMHNP-BC

• Family Nurse Practitioner in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.