Individual provider Active NPI

Maureen M Milota, FPA APRN

  • Family Nurse Practitioner
  • Northbrook, IL
National Provider Identifier
1790076495
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277000079 Issued in IL
Practice address
3000 Dundee Rd Ste 313
Northbrook, IL 60062
Phone
(847) 383-6224
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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 277000079 IL Primary

Addresses

Primary practice location

3000 Dundee Rd Ste 313
Northbrook, IL 60062

Mailing address

3814 N Lawndale Ave
Chicago, IL 60618-4115
Phone (321) 659-7609

Other practice location 1

5425 W. lake street
PCC Austin Family Health Center
Chicago, IL 60644
Phone (773) 378-3347

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
I20110718000160 IL Practitioner - Nurse Practitioner 8527236678 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277000079ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Community Wellness Center CurrentSince Jul 25, 2013 Accepting new patients
PCC Community Wellness Center CurrentSince Jul 25, 2013 Accepting new patients
Mount Sinai Community Foundation CurrentSince Jun 5, 2011 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Mount Sinai Community Foundation Dba Sinai Medical Group CurrentSince Jun 5, 2011 Accepting new patients
Procare Medical Group LLC CurrentSince Jan 1, 2019 Accepting new patients
Behavioral Medicine Associates LTD. CurrentSince Jan 1, 2019 Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

5425 W Lake St
Chicago, IL 60644
Phone (773) 378-3347

3000 Dundee Rd
Ste 313
Northbrook, IL 60062
Phone (847) 383-6224

14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113

Organizations & group practices 7

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": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1790076495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 N LAWNDALE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184115",
            "telephone_number": "321-659-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 DUNDEE RD STE 313",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "60062",
            "telephone_number": "847-383-6224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5425 W. lake street",
            "address_2": "PCC Austin Family Health Center",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60644",
            "country_code": "US",
            "telephone_number": "773-378-3347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILOTA",
        "first_name": "MAUREEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FPA APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277000079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.