Active NPI
Amanda Enno, APN
- Nurse Practitioner
- Skokie, IL
National Provider Identifier
1740714989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209.015883
- Practice address
- 4709 Golf Rd Ste 900
Skokie, IL 60076-1244 - Phone
- (847) 676-5394
- NPI assigned
- Apr 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209.015883 | IL | Primary |
Addresses
Primary practice location
4709 Golf Rd Ste 900
Skokie, IL 60076-1244
Mailing address
4709 Golf Rd Ste 900
Skokie, IL 60076-1244
Phone (847) 676-5394
Other names 1
- Amanda Rolle
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tfrank@kfpp.pcc-direct.com | ||
| Direct Messaging Address | tfrank@kfpp.pcc-direct.com |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 209.015883 | IL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1740714989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4709 GOLF RD STE 900",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761244",
"telephone_number": "847-676-5394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4709 GOLF RD STE 900",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600761244",
"telephone_number": "847-676-5394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNO",
"first_name": "AMANDA",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-14",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209.015883",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tfrank@kfpp.pcc-direct.com",
"affiliation": "N",
"address_1": "4709 Golf Rd Ste 900",
"city": "Skokie",
"state": "IL",
"country_code": "US",
"postal_code": "600761244",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tfrank@kfpp.pcc-direct.com",
"affiliation": "N",
"address_1": "4709 Golf Rd Ste 900",
"city": "Skokie",
"state": "IL",
"country_code": "US",
"postal_code": "600761244",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "ROLLE",
"credential": "APN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.