Individual provider Active NPI

Andrea Dillman, NP

  • Family Nurse Practitioner
  • Willowbrook, IL
National Provider Identifier
1407501224
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.027005 Issued in IL
Practice address
7050 S Madison St
Willowbrook, IL 60527-5548
Phone
(630) 457-8649
Fax
(630) 323-6416
NPI assigned
Feb 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.451302 IL
Family Nurse Practitioner 363LF0000X 209.027005 IL Primary

Addresses

Primary practice location

7050 S Madison St
Willowbrook, IL 60527-5548

Mailing address

7050 S Madison St
Willowbrook, IL 60527-5548
Phone (630) 457-8649

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
I20240119002781 IL Practitioner - Nurse Practitioner 0840642302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

2451 W Touhy Ave
Chicago, IL 60645-3309
Phone (312) 593-5599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.451302ILMDRegistered Nurse
209.027005ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Healthcare LLC CurrentSince Dec 11, 2023 Accepting new patients

Locations

422 E 4th St S
Arcola, IL 61910
Phone (217) 268-3022

2451 W Touhy Ave
Chicago, IL 60645
Phone (312) 593-5599

2201 Main St
Evanston, IL 60202
Phone (847) 905-3000

200 Martin Ave
Naperville, IL 60540
Phone (630) 236-8018

270 Skokie Blvd
Northbrook, IL 60062
Phone (773) 620-1974

7050 S Madison St
Willowbrook, IL 60527
Phone (630) 323-3680

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1407501224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7050 S MADISON ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275548",
            "telephone_number": "630-457-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 S MADISON ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275548",
            "telephone_number": "630-457-8649",
            "fax_number": "630-323-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLMAN",
        "first_name": "ANDREA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.451302",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

Verify at the official NPI Registry.