Sylvere Roland Malonga
Individual provider Active NPI Family Nurse Practitioner · Bolingbrook, IL
NPI 1497311104 · NPPES record last updated Apr 2, 2026
Key facts
- NPI
- 1497311104
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.017752 (IL)
- Practice address
- 1475 Basswood Dr
Bolingbrook, IL 60490-5419 - Phone
- (630) 417-9417
- NPI assigned
- May 17, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 68.65 of 100
- Quality
- 52.24
- Promoting interoperability
- 42
- Improvement activities
- 40
- Cost
- 58.26
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
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Advanced Nursing Care Inc |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) Corporate Director (100%) W-2 Managing Employee (100%) Operational/Managerial Control (100%) |
Jun 15, 2020 May 22, 2024 Jun 15, 2020 May 15, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200529000009 | IL | Practitioner - Nurse Practitioner | 1557272796 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.301622 | IL | MD | Registered Nurse |
| 209.017752 | IL | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forever Care Home Visiting Physicians Inc | Current |
Accepting new patients | |
| Jasyl Medical Services | Current |
Accepting new patients | |
| New Southtown Medical Group S C | Current |
Accepting new patients | |
| Advanced Nursing Care, Inc. | Current |
Accepting new patients | |
| Nurses on Calls, Inc. | Current |
Accepting new patients | |
| Prime Plus Lakeview LLC | Past | Accepting new patients |
Locations
11000 S Halsted St
Chicago, IL 60628
Phone (773) 264-2236
8205 Cass Ave
Ste 110B
Darien, IL 60561
Phone (773) 840-4747
2400 E Devon Ave
Ste 286
Des Plaines, IL 60018
Phone (847) 257-7984
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.301622 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209.017752 | IL | Yes |
| Adult Health Nurse Practitioner | 363LA2200X | 209.017752 | IL |
Addresses
Primary practice location
1475 Basswood Dr
Bolingbrook, IL 60490-5419
Mailing address
1475 Basswood Dr
Bolingbrook, IL 60490-5419
Phone (630) 417-9417
Other providers in Bolingbrook, IL
- Maja Therapeutic Services Inc
- Manuel Alaban Malicay
- Anna Elizabeth Malin
- Lindsey Malloy
- Annie Malone
- Joel D Maloof
- Jennifer Ann Mamak
- Ann Manas
- Gabrielle V Mancuso
- Nibedita Pramanik Mandal
All providers in Bolingbrook, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.