Individual provider Active NPI

Mastura Zalwango, DNP

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1235424565
Registry record updated Oct 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.008743 Issued in IL
Practice address
5250 Old Orchard Rd Ste 300
Skokie, IL 60077-4462
Phone
(872) 600-5700
Fax
(855) 734-3355
NPI assigned
Jun 15, 2011
Last updated
Oct 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.008743 IL Primary

Addresses

Primary practice location

5250 Old Orchard Rd Ste 300
Skokie, IL 60077-4462

Mailing address

8610 Prairie St
Morton Grove, IL 60053-2282
Phone (872) 600-5700

Other practice location 1

6315 W Raven St
Chicago, IL 60646-3615
Phone (872) 600-5700

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL zalwangohealthwellness.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.008743ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Home Care Physicians, Inc. Past Accepting new patients
Covenant Holistic Healthcare Services, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1235424565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 PRAIRIE ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532282",
            "telephone_number": "872-600-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 OLD ORCHARD RD STE 300",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600774462",
            "telephone_number": "872-600-5700",
            "fax_number": "855-734-3355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6315 W Raven St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606463615",
            "country_code": "US",
            "telephone_number": "872-600-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZALWANGO",
        "first_name": "MASTURA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.008743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "zalwangohealthwellness.com",
            "affiliation": "N",
            "endpointDescription": "practice web address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5250 Old Orchard Rd Ste 300",
            "city": "Skokie",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600774462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.