Individual provider Active NPI

Josalynn M Brown, FNP-C

  • Family Nurse Practitioner
  • South Holland, IL
National Provider Identifier
1730545955
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.013005 Issued in IL
Practice address
430 E 162ND St
South Holland, IL 60473-2258
Phone
(708) 880-0559
NPI assigned
Jan 4, 2016
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209013005 IL
Family Nurse Practitioner 363LF0000X 209.013005 IL Primary

Addresses

Primary practice location

430 E 162ND St
South Holland, IL 60473-2258

Mailing address

18039 Vista Dr
Country Club Hills, IL 60478-2940
Phone (708) 328-0802

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
I20160308001383 IL Practitioner - Nurse Practitioner 1153627740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Group LTDGroup PAC ID 1153585658, 7 clinicians

Practice addresses (Care Compare)

4419 W 95TH St
Oak Lawn, IL 60453-7223
Phone (708) 576-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.013005ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Group LTD CurrentSince Aug 29, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Aug 9, 2019 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Aug 9, 2019 Accepting new patients
Specialty Physicians of Illinois, LLC PastSince Feb 8, 2023 Accepting new patients
Community Health Providers PLLC PastSince Feb 4, 2019 Accepting new patients
Faminamed Healthcare Providers SC PastSince Aug 29, 2024 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

600 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 325-9630

9401 S Kostner Ave
Oak Lawn, IL 60453
Phone (708) 423-6731

Organizations & group practices 7

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": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1730545955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18039 VISTA DR",
            "city": "COUNTRY CLUB HILLS",
            "state": "IL",
            "postal_code": "604782940",
            "telephone_number": "708-328-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732258",
            "telephone_number": "708-880-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JOSALYNN",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013005",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.013005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

Verify at the official NPI Registry.