Individual provider Active NPI

Amy Lilly, PMHNP, RN

  • Critical Care Medicine Registered Nurse
  • Chicago, IL
National Provider Identifier
1699494419
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
041443651 Issued in IL
Practice address
1969 W Ogden Ave
Chicago, IL 60612-3765
Phone
(312) 864-6000
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209024086 IL
Critical Care Medicine Registered Nurse 163WC0200X 041443651 IL Primary

Addresses

Primary practice location

1969 W Ogden Ave
Chicago, IL 60612-3765

Mailing address

1864 Fitch CT
Batavia, IL 60510-8361
Phone (630) 669-1558

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
I20230126002244 IL Practitioner - Nurse Practitioner 4183095391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

8321 W N Ave
Melrose Park Family Health Center
Melrose Park, IL 60160-1605
Phone (708) 681-2298

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041443651ILMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Jan 9, 2023 Accepting new patients
Access Community Health Network CurrentSince Jan 9, 2023 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

Interoperability endpoints

  • Direct secure messaging: alilly22876@direct.achn.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1699494419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1864 FITCH CT",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605108361",
            "telephone_number": "630-669-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123765",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "AMY",
        "credential": "PMHNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209024086",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041443651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.