Individual provider Active NPI

Nofal Salman, FNP-C

  • Family Nurse Practitioner
  • Roselle, IL
National Provider Identifier
1790557288
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.028590 Issued in IL
Practice address
57 E Hattendorf Ave Apt 410
Roselle, IL 60172-1570
Phone
(224) 202-1579
NPI assigned
Oct 27, 2023
Last updated
Oct 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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 209.028590 IL Primary

Addresses

Primary practice location

57 E Hattendorf Ave Apt 410
Roselle, IL 60172-1570

Mailing address

57 E Hattendorf Ave Apt 410
Roselle, IL 60172-1570
Phone (224) 202-1579

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
I20240228000605 IL Practitioner - Nurse Practitioner 1658716881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.028590ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jan 15, 2024 Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1790557288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 E HATTENDORF AVE APT 410",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601721570",
            "telephone_number": "224-202-1579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 E HATTENDORF AVE APT 410",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601721570",
            "telephone_number": "224-202-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALMAN",
        "first_name": "NOFAL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.028590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

Verify at the official NPI Registry.