NPIMap

Individual provider Active NPI

Angela Patrick

  • Family Nurse Practitioner
  • Tinley Park, IL
National Provider Identifier
1780068833
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012944 Issued in IL
Practice address
17333 La Grange Rd
Suite 200
Tinley Park, IL 60487-7502
Phone
(708) 342-1900
Fax
(708) 429-3145
NPI assigned
Jul 17, 2015
Last updated
Jul 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209012944 IL Primary

Addresses

Primary practice location

17333 La Grange Rd
Suite 200
Tinley Park, IL 60487-7502

Mailing address

17333 La Grange Rd
Suite 200
Tinley Park, IL 60487-7502
Phone (708) 342-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150908001152 IL Practitioner - Nurse Practitioner 6800102708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affiliated Oncologists LLCGroup PAC ID 2365606563, 43 clinicians

Practice addresses (Care Compare)

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-5475

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Oncologists, LLC CurrentSince Jul 1, 2020 Accepting new patients
Gynecological Cancer Institute of Chicago, LLC PastSince Apr 1, 2015 Accepting new patients
Mobile Anesthesiologists Chicago LLC Past Accepting new patients

Locations

62647 Collection Ctr Dr
Chicago, IL 60693
Phone (708) 478-4302

10604 Southwest Hwy
Ste 109
Chicago Ridge, IL 60415
Phone (708) 529-0156

10604 Southwest Hwy
Ste 200
Chicago Ridge, IL 60415
Phone (708) 634-4644

3825 Highland Ave
Ste 307
Downers Grove, IL 60515
Phone (708) 422-3242

17850 Kedzie Ave
Ste 1500
Hazel Crest, IL 60429
Phone (708) 799-7780

333 Madison St
Ste Cc
Joliet, IL 60435
Phone (815) 773-7439

19060 Everett Blvd
Unit 112
Mokena, IL 60448
Phone (708) 346-4040

1890 Silver Cross Blvd
Ste 535
New Lenox, IL 60451
Phone (708) 342-1900

4301 W 95th St
Oak Lawn, IL 60453
Phone (708) 425-5500

4440 W 95th St
Ste 31W
Oak Lawn, IL 60453
Phone (708) 684-5475

6700 W 95th St
Ste 330
Oak Lawn, IL 60453
Phone (708) 422-3242

82 Orland Square Dr
Orland Park, IL 60462
Phone (224) 273-3590

17333 La Grange Rd
Ste 200
Tinley Park, IL 60487
Phone (708) 342-1900

Interoperability endpoints

  • Direct secure messaging: angela.patrick@affiliatedoncologists.ikm.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1780068833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17333 LA GRANGE RD",
            "address_2": "SUITE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877502",
            "telephone_number": "708-342-1900",
            "fax_number": "708-429-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17333 LA GRANGE RD",
            "address_2": "SUITE 200",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877502",
            "telephone_number": "708-342-1900",
            "fax_number": "708-429-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.