Deidra Hall, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.030954 Issued in IL

Practice address

1616 Grand Ave
Waukegan, IL 60085-3600

Phone

(847) 249-1733

NPI assigned

Dec 3, 2024

Last updated

Jul 18, 2025By the provider in NPPES

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waukegan Clinic CorpGroup PAC ID 4284631086, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vista Medical Center East Hospital, Waukegan, IL, CCN 140084

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: deidra.hall.1@2069.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4

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.

• Waukegan Clinic Corp

  • Family Medicine Physician
  • Waukegan, IL
  • NPI 1306937289
  Medicare reassignment Care Compare group NPD
• New Rose Healthcare Management LLC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1043816515
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL

  Medicare reassignment NPD
• Bloomwell Family Clinic PLLC

  • Clinic/Center
  • Wonder Lake, IL
  • NPI 1316819360
  NPD Authorized official
• Oncology Hematology Associates of Northern Illinois, LTD

  • Hematology & Oncology Physician
  • Gurnee, IL
  • NPI 1093142135
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Waukegan Illinois Hospital Company LLC

  dba Vista Medical Center East

  • General Acute Care Hospital
  • Waukegan, IL
  • NPI 1639120694
  Care Compare affiliation

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1376369553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8702 SEDGE MEADOW DR",
            "city": "WONDER LAKE",
            "state": "IL",
            "postal_code": "600977604",
            "telephone_number": "312-399-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853600",
            "telephone_number": "847-249-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DEIDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.030954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ernest Gene Hall, D.MIN
• Rita M. Hall, FNP
• Amber Hamby
• Hannah Hamlet, RSA
• Heather Jean Hamlet, B.A.

• Family Nurse Practitioner in Waukegan, IL
• Providers in Waukegan, 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 Jul 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.