Individual provider Active NPI

Cornelia Adaji Nkwocha

  • Family Nurse Practitioner
  • Evanston, IL
National Provider Identifier
1205491875
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.019052 Issued in IL
Practice address
2650 Ridge Ave
Evanston, IL 60201-1700
Phone
(847) 570-2000
NPI assigned
May 8, 2019
Last updated
May 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2019

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 209.019052 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200218001310 IL Practitioner - Nurse Practitioner 8123455904 Reassigns benefits to 6 organizations

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
Midwest Post Acute Care PLLCGroup PAC ID 0143547117, 125 clinicians
Midwest Post Acute Care Aco PLLCGroup PAC ID 2961804976, 25 clinicians

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

LicenseStateTypeSpecialty
209.019052ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Post Acute Care PLLC CurrentSince Feb 1, 2026 Accepting new patients
NV Pacs 2 LLC CurrentSince Jul 1, 2021 Accepting new patients
CS Pacs 3 Il, S.C. CurrentSince Feb 1, 2025 Accepting new patients
Illinois Post-Acute Medical Services 1 PC CurrentSince Dec 22, 2019 Accepting new patients
CS Pacs 3 Midwest LLC CurrentSince Sep 26, 2024 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.

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

Sources for this page

Verify at the official NPI Registry.