Individual provider Active NPI

Mankawalpreet Wazir

  • Family Nurse Practitioner
  • Bolingbrook, IL
National Provider Identifier
1568239960
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028597 Issued in IL
Practice address
391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411
Phone
(630) 226-1006
NPI assigned
Dec 6, 2023
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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 209028597 IL Primary

Addresses

Primary practice location

391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411

Mailing address

391 S Bolingbrook Dr
Bolingbrook, IL 60440-3411

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
I20240209000401 IL Practitioner - Nurse Practitioner 0345683009 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
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)

1672 S Galena Ave
Dixon, IL 61021-9611
Phone (815) 564-2663

2322 Route 34
Oswego, IL 60543-7132
Phone (630) 383-7042

2853 Kirk Rd
Aurora, IL 60502-6031
Phone (630) 423-3030

3475 S Alpine Rd
Rockford, IL 61109-2604
Phone (815) 874-8000

405 W Golf Rd
Schaumburg, IL 60195-3501
Phone (224) 215-0011

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

6050 Caton Farm Rd
Plainfield, IL 60586-8218
Phone (815) 609-5501

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Feb 26, 2024 Accepting new patients

Locations

391 S Bolingbrook Dr
Bolingbrook, IL 60440
Phone (630) 226-1006

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

800 W Fulton Market
Fl 12
Chicago, IL 60607

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

534 Randall Rd
South Elgin, IL 60177

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, 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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1568239960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403411",
            "telephone_number": "630-226-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAZIR",
        "first_name": "MANKAWALPREET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.