Individual provider Active NPI

Magdalena Johnson, FNP

  • Nurse Practitioner
  • Burbank, IL
National Provider Identifier
1740090786
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.031068 Issued in IL
Practice address
7786 S Cicero Ave
Burbank, IL 60459-1583
Phone
(708) 425-3085
NPI assigned
Jan 11, 2025
Last updated
Jan 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.031068 IL Primary

Addresses

Primary practice location

7786 S Cicero Ave
Burbank, IL 60459-1583

Mailing address

23025 Arbor Creek Dr
Plainfield, IL 60586-5129
Phone (708) 439-3917

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
I20250204002913 IL Practitioner - Nurse Practitioner 1658801733 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.031068ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Jan 17, 2025 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 17, 2025 Accepting new patients

Locations

7786 S Cicero Ave
Burbank, IL 60459
Phone (708) 425-3085

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

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": "1736553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736553600000",
    "number": "1740090786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23025 ARBOR CREEK DR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605865129",
            "telephone_number": "708-439-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7786 S CICERO AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591583",
            "telephone_number": "708-425-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MAGDALENA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-11",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.031068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

Verify at the official NPI Registry.