Individual provider Active NPI

Adwoa Ofori-Kuragu

  • Psychiatric/Mental Health Nurse Practitioner
  • Bolingbrook, IL
National Provider Identifier
1710762505
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209028472 Issued in IL
Practice address
405 N Ashbury Ave
Bolingbrook, IL 60440-2103
Phone
(630) 885-0310
NPI assigned
Aug 29, 2023
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 209028472 IL Primary

Addresses

Primary practice location

405 N Ashbury Ave
Bolingbrook, IL 60440-2103

Mailing address

405 N Ashbury Ave
Bolingbrook, IL 60440-2103
Phone (630) 885-0310

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
I20240314000354 IL Practitioner - Nurse Practitioner 6103262092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1106 Neal Ave
Joliet, IL 60433-2548
Phone (815) 727-8670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Will County Community Health Center CurrentSince Jan 21, 2024 Accepting new patients
Will County Community Health Center Current Accepting new patients

Locations

391 Quadrangle Dr
Ste 130
Bolingbrook, IL 60440
Phone (630) 679-7000

1106 Neal Ave
Joliet, IL 60433
Phone (815) 727-5054

501 Ella Ave
Joliet, IL 60433
Phone (815) 727-8480

Interoperability endpoints

  • Direct secure messaging: adwoa.oforikuragu.p25@direct.willcounty.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, 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": "1693267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1710762505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N ASHBURY AVE",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402103",
            "telephone_number": "630-885-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N ASHBURY AVE",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402103",
            "telephone_number": "630-885-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFORI-KURAGU",
        "first_name": "ADWOA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209028472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.