Individual provider Active NPI

Tamara L Hauserman-Aggacid

  • Family Nurse Practitioner
  • Mokena, IL
National Provider Identifier
1215371232
Registry record updated Apr 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.010337 Issued in IL
Practice address
11200 Lincoln Hwy
Mokena, IL 60448-8208
Phone
(866) 389-2727
NPI assigned
Apr 21, 2013
Last updated
Apr 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2013

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 209.010337 IL Primary

Addresses

Primary practice location

11200 Lincoln Hwy
Mokena, IL 60448-8208

Mailing address

6611 W Belmont Ave
Unit #3
Chicago, IL 60634-4280
Phone (773) 793-9992

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
I20131127000975 IL Practitioner - Nurse Practitioner 1951537752 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Illinois PLLCGroup PAC ID 8729171566, 106 clinicians
Minuteclinic Primary Care Illinois PLLCGroup PAC ID 7416471842, 102 clinicians

Practice addresses (Care Compare)

2045 Plum Grove Rd
Rolling Meadows, IL 60008-1992
Phone (866) 389-2727

2656 N Elston Ave
Chicago, IL 60647-2019
Phone (866) 389-2727

345 Madison St
Oak Park, IL 60302-4111
Phone (866) 389-2727

3637 N Southport Ave
Chicago, IL 60613-3709
Phone (866) 389-2727

4051 N Lincoln Ave
Chicago, IL 60618-3009
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.010337ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince May 10, 2013 Accepting new patients
Minuteclinic Video Virtual Care North, LLC Family CurrentSince Jan 31, 2023 Accepting new patients
Minuteclinic Primary Care Illinois PLLC Family CurrentSince Apr 15, 2025 Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

3637 N Southport Ave
Chicago, IL 60613
Phone (773) 347-5282

11200 Lincoln Hwy
Mokena, IL 60448
Phone 8154642171 ext. 8221

936 Willow Rd
Northbrook, IL 60062
Phone (847) 209-3814

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

Networks

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

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": "1366502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366502400000",
    "number": "1215371232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 W BELMONT AVE",
            "address_2": "UNIT #3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344280",
            "telephone_number": "773-793-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LINCOLN HWY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488208",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSERMAN-AGGACID",
        "first_name": "TAMARA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-21",
        "last_updated": "2013-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.