Individual provider Active NPI

Parvinder Kaur Randhawa, FNP-BC

  • Family Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1639969850
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209032333 Issued in IL
Practice address
9730 S Western Ave Ste 700
Evergreen Park, IL 60805-2814
Phone
(708) 425-1907
NPI assigned
May 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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 209032333 IL Primary

Addresses

Primary practice location

9730 S Western Ave Ste 700
Evergreen Park, IL 60805-2814

Mailing address

10260 191St St Ste 100
Mokena, IL 60448-8802
Phone (708) 425-1907

Other practice location 1

10260 191st St Ste 100
Mokena, IL 60448-8802
Phone (708) 425-1907

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
I20251007002694 IL Practitioner - Nurse Practitioner 8527565548

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12859 Stellar LN
Plainfield, IL 60585-4210

1879 Bay Scott Cir
Suite 111
Naperville, IL 60540-1108

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209032333ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
A Lota Healthcare LTD CurrentSince Nov 8, 2025 Accepting new patients
Providea Health Partners, LLC CurrentSince Nov 8, 2025 Accepting new patients
Suburban Endocrinology & Diabetes PastSince May 1, 2025 Accepting new patients

Locations

9730 S Western Ave
Ste 700
Evergreen Pk, IL 60805
Phone (708) 425-1907

10260 191st St
Ste 100
Mokena, IL 60448
Phone (708) 425-1907

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.70301

Organizations & group practices 3

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.

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": "1746748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1639969850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10260 191ST ST STE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488802",
            "telephone_number": "708-425-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 S WESTERN AVE STE 700",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052814",
            "telephone_number": "708-425-1907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10260 191st St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488802",
            "country_code": "US",
            "telephone_number": "708-425-1907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDHAWA",
        "first_name": "PARVINDER",
        "middle_name": "KAUR",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209032333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.