Individual provider Active NPI

Suzana Draginis, FPA-APRN, AGNP,IFMCP

  • Adult Health Nurse Practitioner
  • Lake Forest, IL
National Provider Identifier
1730724451
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
277.003847 Issued in IL
Practice address
825 S Waukegan Rd
Lake Forest, IL 60045-2696
Phone
(815) 405-7137
Fax
(833) 800-0135
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 277.003847 IL Primary

Addresses

Primary practice location

825 S Waukegan Rd
Lake Forest, IL 60045-2696

Mailing address

825 S Waukegan Rd Ste A8
Lake Forest, IL 60045-2665
Phone (815) 405-7137

Other identifiers 1

IdentifierTypeStateIssuer
277.003847OtherILSTATE OF ILLINOIS FULL PRACTICE AUTHORITY

Other names 1

  • Suzana Nikitovic Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
277.003847ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alan Tony Amberg PLLC PastSince Feb 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21991/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1730724451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 S WAUKEGAN RD STE A8",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452665",
            "telephone_number": "815-405-7137",
            "fax_number": "833-800-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S WAUKEGAN RD",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452696",
            "telephone_number": "815-405-7137",
            "fax_number": "833-800-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGINIS",
        "first_name": "SUZANA",
        "credential": "FPA-APRN, AGNP,IFMCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "277.003847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS FULL PRACTICE AUTHORITY",
            "identifier": "277.003847",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANA",
            "last_name": "NIKITOVIC",
            "credential": "FPA-APRN, AGNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.