Individual provider Active NPI

Olga Kruglova, APN-CNP

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1396573077
Registry record updated Aug 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209030104 Issued in IL
Practice address
9977 Woods Dr Ste 100
Skokie, IL 60077-1057
Phone
(224) 364-2273
NPI assigned
Jul 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209030104 IL Primary

Addresses

Primary practice location

9977 Woods Dr Ste 100
Skokie, IL 60077-1057

Mailing address

9977 Woods Dr Ste 100
Skokie, IL 60077-1057
Phone (224) 364-2273

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
I20240828001861 IL Practitioner - Nurse Practitioner 5496294951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1000 E Rollins Rd
Round Lake Beach, IL 60073-2228
Phone (224) 364-2273

1162 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 367-2400

2650 Ridge Ave
Evanston, IL 60201-1700

501 Skokie Blvd
Northbrook, IL 60062-2802
Phone (847) 504-2300

71 Waukegan Rd
Suite 700
Lake Bluff, IL 60044-1614
Phone (224) 364-2273

7900 Rollins Rd
Gurnee, IL 60031-1512

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209030104ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Aug 1, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Aug 1, 2024 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

9933 Woods Dr
Skokie, IL 60077
Phone (847) 663-8060

9977 Woods Dr
Ste 100
Skokie, IL 60077
Phone (847) 663-8350

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1396573077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 100",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR STE 100",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUGLOVA",
        "first_name": "OLGA",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209030104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.