Individual provider Active NPI

Kofi Ankomah, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1356925440
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209023280 Issued in IL
Practice address
4840 W Byron St
Chicago, IL 60641-2712
Phone
(773) 282-7800
Fax
(773) 282-2163
NPI assigned
May 6, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209023280 IL Primary
Family Nurse Practitioner 363LF0000X 2021013060 IL

Addresses

Primary practice location

4840 W Byron St
Chicago, IL 60641-2712

Mailing address

4840 W Byron St
Chicago, IL 60641-2712
Phone (224) 866-9641

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
I20211005000466 IL Practitioner - Nurse Practitioner 7214335363 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4840 W Byron St
Chicago, IL 60641-2712
Phone (773) 282-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021013060ILMDFamily Nurse Practitioner
2023032820ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Social Services of Illinois CurrentSince Aug 19, 2024 Accepting new patients
Integra Medical Doctors Inc CurrentSince Aug 1, 2021 Accepting new patients
Lutheran Social Services of Illinois CurrentSince Aug 19, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jun 1, 2024 Accepting new patients
Vpa PC CurrentSince Jul 1, 2023 Accepting new patients
Vpa PC CurrentSince Jul 1, 2023 Accepting new patients

Locations

5517 N Kenmore Ave
Chicago, IL 60640
Phone (773) 275-7962

4840 W Byron St
Chicago, IL 60641
Phone (773) 282-7800

1001 E Touhy Ave
Ste 170
Des Plaines, IL 60018
Phone (847) 390-1422

675 Varsity Dr
Elgin, IL 60120
Phone (833) 610-5774

2815 Forbs Ave
Ste 107
Hoffman Estates, IL 60192
Phone (224) 765-0100

2815 Forbs Ave
Ste 126
Hoffman Estates, IL 60192
Phone (708) 529-7359

1901 1st Ave
Sterling, IL 61081
Phone (815) 490-1125

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1356925440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 W BYRON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412712",
            "telephone_number": "224-866-9641",
            "fax_number": "773-282-2163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 W BYRON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412712",
            "telephone_number": "773-282-7800",
            "fax_number": "773-282-2163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKOMAH",
        "first_name": "KOFI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209023280",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "2021013060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.