Individual provider Active NPI

Rajwant Kaur Sohal

  • Primary Care Nurse Practitioner
  • Bolingbrook, IL
National Provider Identifier
1205548088
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209026562 Issued in IL
Practice address
730 S Weber Rd Ste G
Bolingbrook, IL 60490-5472
Phone
(378) 630-2000
NPI assigned
Dec 23, 2022
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209026562 IL Primary

Addresses

Primary practice location

730 S Weber Rd Ste G
Bolingbrook, IL 60490-5472

Mailing address

730 S Weber Rd Ste G
Bolingbrook, IL 60490-5472
Phone (378) 630-2000

Other names 1

  • Rajwant Kaur Former name

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
I20231201000441 IL Practitioner - Nurse Practitioner 7911355995 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

2600 E Main St
Saint Charles, IL 60174-2469
Phone (847) 653-0130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209026562ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Medical Plus CurrentSince Oct 1, 2024 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince Jan 26, 2024 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Jan 2, 2025 Accepting new patients

Locations

800 W Fulton Market
Fl 12
Chicago, IL 60607

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

1420 Busse Rd
Elk Grove Vlg, IL 60007
Phone (847) 653-0142

2600 E Main St
Saint Charles, IL 60174
Phone (847) 653-0130

233 Saratoga Rd
Glenville, NY 12302
Phone (518) 930-7497

424 Church St
Ste 2600
Nashville, TN 37219
Phone (480) 450-3721

Interoperability endpoints

  • Direct secure messaging: rajwant.sohal.1@14522.direct.athenahealth.com

Organizations & group practices 3

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": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1205548088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S WEBER RD STE G",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905472",
            "telephone_number": "378-630-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S WEBER RD STE G",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905472",
            "telephone_number": "378-630-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHAL",
        "first_name": "RAJWANT",
        "middle_name": "KAUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209026562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAJWANT",
            "last_name": "KAUR",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.