Individual provider Active NPI

Assumpta E Ike, FNP-C

  • Family Nurse Practitioner
  • Lansing, IL
National Provider Identifier
1508585993
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
015350 Issued in IL
Practice address
3434 Ridge Rd
Lansing, IL 60438-3102
Phone
(708) 858-6132
NPI assigned
Aug 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 015350 IL Primary

Addresses

Primary practice location

3434 Ridge Rd
Lansing, IL 60438-3102

Mailing address

20000 Cypress Ave
Lynwood, IL 60411-6836
Phone (708) 717-1107

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
I20250226001484 IL Practitioner - Nurse Practitioner 5799053393 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
015350ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Home Health Care Inc. CurrentSince May 12, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 1, 2025 Accepting new patients

Locations

3434 Ridge Rd
Lansing, IL 60438
Phone (708) 858-6132

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1508585993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20000 CYPRESS AVE",
            "city": "LYNWOOD",
            "state": "IL",
            "postal_code": "604116836",
            "telephone_number": "708-717-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 RIDGE RD",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383102",
            "telephone_number": "708-858-6132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKE",
        "first_name": "ASSUMPTA",
        "middle_name": "E",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "015350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, IL

Sources for this page

Verify at the official NPI Registry.