Individual provider Active NPI

Faustina Nkolika Anikamadu, FNP-BC

  • Family Nurse Practitioner
  • Lake in the Hills, IL
National Provider Identifier
1366258493
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209029292 Issued in IL
Practice address
420 Wright Dr
Lake in the Hills, IL 60156-6234
Phone
(847) 971-9631
NPI assigned
Dec 4, 2024
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209029292 IL Primary

Addresses

Primary practice location

420 Wright Dr
Lake in the Hills, IL 60156-6234

Mailing address

420 Wright Dr
Lake in the Hills, IL 60156-6234
Phone (847) 971-9631

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
209029292ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Home Health Inc. PastSince Dec 8, 2024 Accepting new patients

Organizations & group practices 1

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": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1366258493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WRIGHT DR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566234",
            "telephone_number": "847-971-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WRIGHT DR",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601566234",
            "telephone_number": "847-971-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANIKAMADU",
        "first_name": "FAUSTINA",
        "middle_name": "NKOLIKA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209029292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.