Amanda Kostic, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.023424 Issued in IL

Practice address

222 W Ontario St Ste 310
Chicago, IL 60654-3621

Phone

(312) 880-9697

NPI assigned

Jun 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Balanced Flow Life LLC

  • Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
  • Chicago, IL
  • NPI 1982488045
  NPD

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1629648225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W ONTARIO ST STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543621",
            "telephone_number": "312-880-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W ONTARIO ST STE 310",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543621",
            "telephone_number": "312-880-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSTIC",
        "first_name": "AMANDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Konstantinos D Kostas, PHD
• Tia Kostas
• Grant Ryan Koster, PT, MSPT, ATC, CSCS
• Anna Kostevich, MD
• Aleksandra Kostic, MD
• Jasminka Kostic, MD
• Camryn Mae Kostick, MA
• Rickie Kostiner, MA, LCPC
• Caroline Ann Kostiuk
• Kari Shay Kostopoulos

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.