A & S Divine Healthcare Services PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

A & S DIVINE HEALTHCARE SERVICES PLLC

Practice address

1477 Ring Rd
Calumet City, IL 60409-5459

Phone

(708) 933-6346

Fax

(708) 933-6356

NPI assigned

Apr 21, 2021

Last updated

Nov 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angel White, DNP, APRN, FNP-BCNPI 1710340658

Title

Co-Owner/Family Nurse Practitioner

Phone

(708) 933-6346

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angel White, DNP, APRN, FNP-BC

  • Family Nurse Practitioner
  • Calumet City, IL
  • NPI 1710340658
  Medicare reassignment Care Compare group NPD Authorized official
• Shadae Booker-Shelton, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1306475488
  Medicare reassignment Care Compare group NPD
• Janice Marea Pierson, M.D.

  • Internal Medicine Physician
  • Palos Heights, IL
  • NPI 1255329546
  NPD

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1215519038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 RING RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095459",
            "telephone_number": "708-933-6346",
            "fax_number": "708-933-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1477 RING RD",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095459",
            "telephone_number": "708-933-6346",
            "fax_number": "708-933-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A & S DIVINE HEALTHCARE SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "CO-OWNER/FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "708-933-6346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oluwafunke Adebanji, LPC,CRC
• Johnson O Adeleke

• Family Nurse Practitioner in Calumet City, IL
• Providers in Calumet City, 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 Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.