Philsy Jomon Edakara, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.020369 Issued in IL

Practice address

8015 S Luella Ave Ste 212
Chicago, IL 60617-1151

Phone

(773) 721-0470

NPI assigned

Jan 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elsie R. Walker M. D., P. C.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1184805277
  NPD (past)

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1316587371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 HALLBERG LN",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8015 S LUELLA AVE STE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171151",
            "telephone_number": "773-721-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDAKARA",
        "first_name": "PHILSY",
        "middle_name": "JOMON",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.020369",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.020369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Eckstein
• Eclipse Sports Rehab and Performance
• Eco Logistics LTD
• Ecuamachines Inc.
• Russell Edafetanure-Ibeh
• Seara Edassery, PHARMD
• Deborah Lynne Edberg, M.D.
• Eddi Care LLC
• Eddie Taylor PHD PLLC
• Sherida Naing Edding, M.D.

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.