Individual provider Active NPI

Maryna Haponava, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1669339974
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209034309 Issued in IL
Practice address
4711 Golf Rd Ste 1200
Skokie, IL 60076-1200
Phone
(847) 563-4488
Fax
(847) 929-9355
NPI assigned
Jan 7, 2026
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209034309 IL Primary

Addresses

Primary practice location

4711 Golf Rd Ste 1200
Skokie, IL 60076-1200

Mailing address

4711 Golf Rd Ste 1200
Skokie, IL 60076-1200
Phone (847) 563-4488

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
I20260212003648 IL Practitioner - Nurse Practitioner 5991285637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Psychiatric Wellness LPGroup PAC ID 4688777428, 9 clinicians

Practice addresses (Care Compare)

4711 Golf Rd
Suite 1200
Skokie, IL 60076-1200
Phone (847) 563-4488

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209034309ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Psychiatric Wellness, LP CurrentSince Jan 13, 2026 Accepting new patients

Locations

4711 Golf Rd
Ste 1200
Skokie, IL 60076
Phone (847) 563-4488

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, 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": "1767744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1669339974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761200",
            "telephone_number": "847-563-4488",
            "fax_number": "847-929-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 1200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761200",
            "telephone_number": "847-563-4488",
            "fax_number": "847-929-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAPONAVA",
        "first_name": "MARYNA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209034309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.