Individual provider Active NPI

Abena Konadu Poku

  • Nurse Practitioner
  • Homewood, IL
National Provider Identifier
1497441919
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027156 Issued in IL
Practice address
1843 Cedar Rd
Homewood, IL 60430-1309
Phone
(312) 833-1762
NPI assigned
Apr 17, 2023
Last updated
Apr 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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 209027156 IL Primary

Addresses

Primary practice location

1843 Cedar Rd
Homewood, IL 60430-1309

Mailing address

1843 Cedar Rd
Homewood, IL 60430-1309
Phone (312) 833-1762

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
I20230726002011 IL Practitioner - Nurse Practitioner 3476914276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jun 15, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Jun 15, 2023 Accepting new patients
University of Chicago CurrentSince Jun 15, 2023 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: apoku273469@uchospital.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1497441919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 CEDAR RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301309",
            "telephone_number": "312-833-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 CEDAR RD",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301309",
            "telephone_number": "312-833-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKU",
        "first_name": "ABENA",
        "middle_name": "KONADU",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.