Individual provider Active NPI

Andrea Nicole Lindholm, FNP-BC

  • Family Nurse Practitioner
  • Joliet, IL
National Provider Identifier
1548970049
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.025871 Issued in IL
Practice address
1316 Black Rd
Joliet, IL 60435-3962
Phone
(815) 207-9050
NPI assigned
Nov 25, 2022
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 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 209.025871 IL Primary

Addresses

Primary practice location

1316 Black Rd
Joliet, IL 60435-3962

Mailing address

1316 Black Rd
Joliet, IL 60435-3962
Phone (815) 207-9050

Other practice location 1

40 75th St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

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
I20230119001259 IL Practitioner - Nurse Practitioner 4981075447 Reassigns benefits to 3 organizations

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
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

800 N Larkin Ave
Joliet, IL 60435-3429
Phone (815) 741-4300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.025871ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Aug 28, 2023 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Nov 23, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Nov 23, 2022 Accepting new patients

Locations

1663 Belvidere Rd
Belvidere, IL 61008
Phone (815) 544-0040

2070 N State Route 50
Ste 500
Bourbonnais, IL 60914
Phone (779) 236-4094

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

800 N Larkin Ave
Joliet, IL 60435
Phone (815) 741-4300

29 N Northwest Hwy
Palatine, IL 60067
Phone (847) 931-5555

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1548970049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 BLACK RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353962",
            "telephone_number": "815-207-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 BLACK RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604353962",
            "telephone_number": "815-207-9050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 75th St",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605272325",
            "country_code": "US",
            "telephone_number": "630-581-5372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDHOLM",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.