Individual provider Active NPI

Aakanksha P. Surti, APN-CNP

  • Nurse Practitioner
  • Niles, IL
National Provider Identifier
1699318568
Registry record updated Jan 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020196 Issued in IL
Practice address
6450 W Touhy Ave # 2
Niles, IL 60714-4512
Phone
(773) 293-4710
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209020196 IL Primary

Addresses

Primary practice location

6450 W Touhy Ave # 2
Niles, IL 60714-4512

Mailing address

6450 W Touhy Ave # 2
Niles, IL 60714-4512
Phone (773) 293-4710

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
I20210607000864 IL Practitioner - Nurse Practitioner 6305246703 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209020196ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 14, 2024 Accepting new patients

Locations

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

6450 W Touhy Ave
#2
Niles, IL 60714
Phone (773) 293-4710

6450 W Touhy Ave
Niles, IL 60714
Phone (847) 583-1000

Organizations & group practices 2

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": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642809600000",
    "number": "1699318568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 W TOUHY AVE # 2",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144512",
            "telephone_number": "773-293-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 W TOUHY AVE # 2",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144512",
            "telephone_number": "773-293-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURTI",
        "first_name": "AAKANKSHA",
        "middle_name": "P.",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2022-01-22",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

Verify at the official NPI Registry.