Active NPI
Cornelia Adaji Nkwocha
- Family Nurse Practitioner
- Evanston, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.019052
- Practice address
- 2650 Ridge Ave
Evanston, IL 60201-1700 - Phone
- (847) 570-2000
- NPI assigned
- May 8, 2019
- Last updated
- May 8, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.019052 | IL | Primary |
Addresses
Primary practice location
2650 Ridge Ave
Evanston, IL 60201-1700
Mailing address
3136 W Fargo Ave
Chicago, IL 60645-1110
Phone (773) 771-5080
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11401 S Oakley Ave
Chicago, IL 60643-4196
Phone (888) 705-8722
11401 S Oakley Ave
Chicago, IL 60643-4197
Phone (773) 233-6311
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.019052 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Post Acute Care PLLC | Current | Accepting new patients | |
| NV Pacs 2 LLC | Current | Accepting new patients | |
| CS Pacs 3 Il, S.C. | Current | Accepting new patients | |
| Illinois Post-Acute Medical Services 1 PC | Current | Accepting new patients | |
| CS Pacs 3 Midwest LLC | Current | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
11401 S Oakley Ave
Chicago, IL 60643
Phone (733) 233-6311
2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437
2829 S California Ave
Chicago, IL 60608
Phone (646) 431-0013
1610 N Lakewood Dr
Effingham, IL 62401
Phone (217) 347-7470
600 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 325-9630
1055 E Grand Ave
Lindenhurst, IL 60046
Phone (847) 356-4559
1666 Checker Rd
Long Grove, IL 60047
Phone (847) 419-1111
1006 N Lowden Rd
Mount Carroll, IL 61053
Phone (815) 244-7715
6930 W Touhy Ave
Niles, IL 60714
Phone (847) 588-5311
1001 N Greenwood Ave
Park Ridge, IL 60068
Phone (847) 685-2805
612 W Saint Marys Rd
Sterling, IL 61081
Phone (815) 626-9020
Organizations & group practices 6
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.
-
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- Chicago, IL
- NPI 1083012074
-
- Nurse Practitioner
- Chicago, IL
- NPI 1457926537
-
- Hospitalist Physician
- Park Ridge, IL
- NPI 1598577124
-
- Hospitalist Physician
- Hinsdale, IL
- NPI 1952830853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557273600000",
"number": "1205491875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3136 W FARGO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606451110",
"telephone_number": "773-771-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 RIDGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602011700",
"telephone_number": "847-570-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NKWOCHA",
"first_name": "CORNELIA",
"middle_name": "ADAJI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-08",
"last_updated": "2019-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.019052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evanston, IL
- Swarupa Injeti Nimmagadda, M.D.
- Laura Nitahara, APN-CNP
- Karoon Nititham, M.D.
- Martin Nitsun, M.D.
- Rehan Ahmed Nizamuddin, M.D.
- Nolan K M Chun DDS PC (Evanston Dental Care)
- Robert J. Noone, PH.D
- Christopher Nora, MS, MA, LPC, LCPC
- North Shore Associates in Gynecology and Obstetrics, S.C.
- North Shore Consultants in Nephrology & Hypertension, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.