Dina M Froustis, APRN, NP-C

Individual provider Active NPI Nurse Practitioner · Libertyville, IL

NPI 1487224747 · NPPES record last updated Jun 29, 2021

Key facts

NPI
1487224747
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
209023434 (IL)
Practice address
1860 W Winchester Rd Ste 106
Libertyville, IL 60048-5312
Phone
(847) 816-6335
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chicago Integrative Center for Psychology LLC (10 clinicians)

Practice addresses (Care Compare)

900 N Shore Dr
Suite 120
Lake Bluff, IL 60044-2225
Phone (847) 615-1698

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230309001088 IL Practitioner - Nurse Practitioner 3072983634 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
209023434ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chicago Integrative Center for Psychology LLC Current
since Feb 1, 2023
Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Past
since Jul 4, 2021
Accepting new patients

Locations

900 N Shore Dr
Ste 120
Lake Bluff, IL 60044
Phone (847) 615-1698

8707 Skokie Blvd
Ste 210
Skokie, IL 60077
Phone (847) 615-1698

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209023434 IL Yes

Addresses

Primary practice location

1860 W Winchester Rd Ste 106
Libertyville, IL 60048-5312

Mailing address

1860 W Winchester Rd
Libertyville, IL 60048-5351
Phone (847) 816-6335

Other providers in Libertyville, IL

All providers in Libertyville, IL · Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.