Individual provider Active NPI

Kelly Filip, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Bolingbrook, IL
National Provider Identifier
1740778034
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209.015863 Issued in IL
Practice address
440 Quadrangle Dr Ste G
Bolingbrook, IL 60440-3455
Phone
(888) 444-8341
NPI assigned
Apr 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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 209.015863 IL Primary

Addresses

Primary practice location

440 Quadrangle Dr Ste G
Bolingbrook, IL 60440-3455

Mailing address

440 Quadrangle Dr Ste G
Bolingbrook, IL 60440-3455

Other practice location 1

77 N Airlite St
Elgin, IL 60123-4912
Phone (847) 695-3200

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
I20180626000918 IL Practitioner - Nurse Practitioner 8224383641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Angels Grace Hospice LLCGroup PAC ID 4587824925, 3 clinicians

Practice addresses (Care Compare)

Bolingbrook, IL 60440
Phone (888) 444-8341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.015863ILMDAdult Health Nurse Practitioner

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": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1740778034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 QUADRANGLE DR STE G",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 QUADRANGLE DR STE G",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403455",
            "telephone_number": "888-444-8341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 N Airlite St",
            "address_purpose": "LOCATION",
            "city": "Elgin",
            "state": "IL",
            "postal_code": "601234912",
            "country_code": "US",
            "telephone_number": "847-695-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FILIP",
        "first_name": "KELLY",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.015863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.