Queen Ajiere

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Frankfort, IL

NPI 1730890898 · NPPES record last updated Dec 9, 2022

Key facts

NPI
1730890898
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
209026557 (IL)
Practice address
10209 W Lincoln Hwy
Frankfort, IL 60423-1279
Phone
(708) 998-2979
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zoelife Healthcare Services Inc (8 clinicians)

Practice addresses (Care Compare)

10209 W Lincoln Hwy
Frankfort, IL 60423-1279
Phone (708) 998-2979

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230203001794 IL Practitioner - Nurse Practitioner 3577935386 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
209026557ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Zoelife Healthcare Services Inc Psychiatric/Mental Health Current
since Dec 9, 2022
Accepting new patients
Hometown Primary Care of Frankfort PLLC Psychiatric/Mental Health Past
since Apr 24, 2022
Accepting new patients

Locations

10209 W Lincoln Hwy
Frankfort, IL 60423
Phone (708) 998-2979

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026557 IL Yes

Addresses

Primary practice location

10209 W Lincoln Hwy
Frankfort, IL 60423-1279

Mailing address

10209 W Lincoln Hwy
Frankfort, IL 60423-1279
Phone (708) 998-2979

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL kareo Direct

Other providers in Frankfort, IL

All providers in Frankfort, IL · Psychiatric/Mental Health Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.