Jill Colleen Zupansic, APN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023470 Issued in IL

Practice address

500 Park Ave Ste 104
Lake Villa, IL 60046-6550

Phone

(847) 245-8700

NPI assigned

Jun 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Family Care of Lake County S.C.

  • Family Medicine Physician
  • Lake Villa, IL
  • NPI 1861485658
  Medicare reassignment NPD
• Eugene Pomeranets M.D.S.C.,

  • Family Medicine Physician
  • Lake Villa, IL
  • NPI 1679056618
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1346810488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 CEDAR CREEK DR",
            "city": "JOHNSBURG",
            "state": "IL",
            "postal_code": "600516367",
            "telephone_number": "847-561-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE STE 104",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600466550",
            "telephone_number": "847-245-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUPANSIC",
        "first_name": "JILL",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Kim Wodrich, LPC, NCC
• Wound Wellness, PLLC
• Kiwan L Wright, DO
• Sarah Nicole Yopp
• Julie Young

• Family Nurse Practitioner in Lake Villa, IL
• Providers in Lake Villa, 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 Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.