Individual provider Active NPI

Latura Stigall, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Homewood, IL
National Provider Identifier
1790418416
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024982 Issued in IL
Practice address
1650 187TH St
Homewood, IL 60430-3852
Phone
(773) 368-9302
NPI assigned
Jul 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 209024982 IL Primary

Addresses

Primary practice location

1650 187TH St
Homewood, IL 60430-3852

Mailing address

2020 W Harrison St
Chicago, IL 60612-3741
Phone (312) 572-2416

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
I20221214002812 IL Practitioner - Nurse Practitioner 5294104212 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
74.7
Promoting interoperability
100
Improvement activities
40
Cost
85.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209024982ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 10, 2022 Accepting new patients
Chicagoland Infectious Disease PC CurrentSince Jun 2, 2025 Accepting new patients
Cook County CurrentSince Nov 10, 2022 Accepting new patients
Impact Physician Group, Washington LLC Past Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2020 W Harrison St
Chicago, IL 60612
Phone (312) 572-4500

17901 Governors Hwy
Ste 206
Homewood, IL 60430
Phone (708) 957-9100

17901 Governors Hwy
Ste 209
Homewood, IL 60430
Phone (708) 942-1276

430 E 162nd St
South Holland, IL 60473
Phone (312) 504-5757

Organizations & group practices 5

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": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1790418416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123741",
            "telephone_number": "312-572-2416",
            "fax_number": "312-572-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 187TH ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604303852",
            "telephone_number": "773-368-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIGALL",
        "first_name": "LATURA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-09",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.