Diesawit T Hansom, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277.004265 Issued in IL

Practice address

1366 S Milwaukee Ave
Libertyville, IL 60048-3795

Phone

(847) 236-0323

NPI assigned

Oct 20, 2022

Last updated

Jun 12, 2025By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Your Healthcare Source PLLCGroup PAC ID 6709320526, 5 clinicians

Lake County Immediate Care, LLCGroup PAC ID 6204158280, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lake County Immediate Care, LLC

  dba PromptMed Urgent Care

  • Urgent Care Clinic/Center
  • Waukegan, IL
  • NPI 1285048975
  Medicare reassignment Care Compare group NPD
• Your Healthcare Source PLLC

  • Urgent Care Clinic/Center
  • Libertyville, IL
  • NPI 1811740046
  Medicare reassignment Care Compare group NPD
• Midwest Express Care 2, Inc

  • Urgent Care Clinic/Center
  • Willowbrook, IL
  • NPI 1548692890
  Medicare reassignment NPD
• Prestige Aesthetics and Hydration Lounge

  • Family Nurse Practitioner
  • Gurnee, IL
  • NPI 1720774938
  NPD Authorized official
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  IL

  Medicare reassignment
• Lake County Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Antioch, IL
  • NPI 1265090849
  NPD
• Midwest Express Care 2, Inc

  dba Midwest Express Clinic

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1659952554
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1689391633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1366 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483795",
            "telephone_number": "847-236-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483795",
            "telephone_number": "847-236-0323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSOM",
        "first_name": "DIESAWIT",
        "middle_name": "T",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.004265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Hamlyn, LCPC
• Joseph Wayne Hamman, D.D.S.
• Phyllis H Han, MD
• Handi Products, Inc. (Handi-Ramp)
• Caitlyn Marie Hansen
• Deane R. Happ, MSW, LCSW
• Natalie Harding, DPT
• Stephen Harper Jr., PHARM.D.
• Christopher E.C. Harris, M.D.
• Shane Stephen Harris, PA

• Family Nurse Practitioner in Libertyville, IL
• Providers in Libertyville, 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 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.