Individual provider Active NPI

Jordanah Marissa Evans, MSN, APRN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Northbrook, IL
National Provider Identifier
1629944053
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209031207 Issued in IL
Practice address
1143 Williamsburg Dr
Northbrook, IL 60062-1573
Phone
(224) 436-3524
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209031207 IL Primary

Addresses

Primary practice location

1143 Williamsburg Dr
Northbrook, IL 60062-1573

Mailing address

1143 Williamsburg Dr
Northbrook, IL 60062-1573

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
I20260129001462 IL Practitioner - Nurse Practitioner 5092293266 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
Comprehensive Renal Care PLLCGroup PAC ID 1456883495, 7 clinicians

Practice addresses (Care Compare)

999 Oakmont Plaza Dr
Suite 600
Westmont, IL 60559-1374
Phone (877) 630-7277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
209031207ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Renal Care PLLC CurrentSince Jan 2, 2026 Accepting new patients

Locations

999 Oakmont Plaza Dr
Ste 600
Westmont, IL 60559
Phone (630) 880-3388

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1629944053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 WILLIAMSBURG DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 WILLIAMSBURG DR",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621573",
            "telephone_number": "224-436-3524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "JORDANAH",
        "middle_name": "MARISSA",
        "credential": "MSN, APRN, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209031207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.