Individual provider Active NPI

Brittany M Wirkus, APN

  • Gerontology Nurse Practitioner
  • Oak Lawn, IL
National Provider Identifier
1518653674
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
041438614 Issued in IL
Practice address
4400 W 95TH St Ste 308
Oak Lawn, IL 60453-2660
Phone
(708) 346-4040
Fax
(708) 346-3287
NPI assigned
Apr 12, 2023
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 041438614 IL Primary

Addresses

Primary practice location

4400 W 95TH St Ste 308
Oak Lawn, IL 60453-2660

Mailing address

4400 W 95TH St Ste 308
Oak Lawn, IL 60453-2660
Phone (708) 346-4040

Other names 1

  • Brittany M Pole Former name

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
I20230828003363 IL Practitioner - Nurse Practitioner 5991168650 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
Cardiothoracic and Vascular Surgical Associates S CGroup PAC ID 7214916402, 48 clinicians

Practice addresses (Care Compare)

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041438614ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiothoracic & Vascular Surgical Associates S C CurrentSince Jul 1, 2023 Accepting new patients

Locations

890 Garfield Ave
Ste 101
Libertyville, IL 60048
Phone (847) 990-5636

4400 W 95th St
Ste 308
Oak Lawn, IL 60453
Phone (708) 346-4040

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

Organizations & group practices 1

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 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": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1518653674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 308",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532660",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 95TH ST STE 308",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532660",
            "telephone_number": "708-346-4040",
            "fax_number": "708-346-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRKUS",
        "first_name": "BRITTANY",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "041438614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "POLE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.