Lidia Maria Andruszyn, DNP, FPA APRN, CPC

Individual provider Active NPI Gerontology Nurse Practitioner · Chicago, IL

NPI 1457324311 · NPPES record last updated May 17, 2023

Key facts

NPI
1457324311
Entity type
Individual (NPI type 1)
Primary specialty
Gerontology Nurse Practitioner 363LG0600X
License
277000162 (IL)
Practice address
6348 N Milwaukee Ave # 370
Chicago, IL 60646-3728
Phone
(847) 507-1548
Fax
(773) 792-0946
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 2, 2022 through Sep 2, 2026

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Visiting Physicians LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 277000162 IL Yes

Addresses

Primary practice location

6348 N Milwaukee Ave # 370
Chicago, IL 60646-3728

Mailing address

6348 N Milwaukee Ave # 370
Chicago, IL 60646-3728
Phone (847) 507-1548

Other providers in Chicago, IL

All providers in Chicago, IL · Gerontology Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.