Individual provider Active NPI

Alyssa Brown, DNP, AGACNP-BC

  • Nurse Practitioner
  • Lake Forest, IL
National Provider Identifier
1497475594
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209026106 Issued in IL
Practice address
1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone
(847) 535-7647
Fax
(847) 535-7260
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 209026106 IL Primary

Addresses

Primary practice location

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658

Mailing address

1000 N Westmoreland Rd # Level1
Lake Forest, IL 60045-1658
Phone (847) 535-7647

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
I20221026000467 IL Practitioner - Nurse Practitioner 1355717778 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
Alexian Brothers Medical Group Specialty CareGroup PAC ID 1456636612, 22 clinicians

Practice addresses (Care Compare)

1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 685-6383

1555 N Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 437-5500

7001 W Cullom Ave
Norridge, IL 60706-7100
Phone (847) 252-6090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209026106ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alexian Brothers Medical Group Specialty Care CurrentSince Aug 1, 2024 Accepting new patients
Central Dupage Physician Group PastSince Dec 18, 2022 Accepting new patients

Locations

800 Biesterfield Rd
Ste 510
Elk Grove Vlg, IL 60007
Phone (847) 981-3360

7001 W Cullom Ave
Norridge, IL 60706
Phone (414) 721-8669

25 E Schaumburg Rd
Ste 101
Schaumburg, IL 60194
Phone (630) 333-6218

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.

Hospital & facility affiliations 2

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1497475594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-7647",
            "fax_number": "847-535-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N WESTMORELAND RD # LEVEL1",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451658",
            "telephone_number": "847-535-7647",
            "fax_number": "847-535-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ALYSSA",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209026106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.