Individual provider Active NPI

Ancy Joice Pappan, FNP-C

  • Family Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1811508799
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01072000 Issued in NJ
Practice address
17243 Grange Dr
Orland Park, IL 60467-7589
Phone
(718) 809-3760
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.030848 IL
Family Nurse Practitioner 363LF0000X 26NJ01072000 NJ Primary
Registered Nurse 163W00000X 041.575592 IL
Registered Nurse 163W00000X 26NR15812700 NJ

Addresses

Primary practice location

17243 Grange Dr
Orland Park, IL 60467-7589

Mailing address

17243 Grange Dr
Orland Park, IL 60467-7589
Phone (718) 809-3760

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
I20241111002258 IL Practitioner - Nurse Practitioner 4789086927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longevity Accountable Care, PAGroup PAC ID 0840734034, 3 clinicians

Practice addresses (Care Compare)

6300 N California Ave
Chicago, IL 60659-1702
Phone (773) 973-1900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.575592ILMDRegistered Nurse
26NR15812700NJMDRegistered Nurse
209.030848ILMDNurse Practitioner
26NJ01072000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Accountable Care, PA CurrentSince Dec 2, 2024 Accepting new patients
Longevity Accountable Care, PA CurrentSince Dec 2, 2024 Accepting new patients

Locations

6300 N California Ave
Chicago, IL 60659
Phone (773) 338-4244

900 S Rand Rd
Lake Zurich, IL 60047
Phone (847) 726-1200

Organizations & group practices 2

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1811508799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17243 GRANGE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677589",
            "telephone_number": "718-809-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17243 GRANGE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677589",
            "telephone_number": "718-809-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAN",
        "first_name": "ANCY",
        "middle_name": "JOICE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.030848",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01072000",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.575592",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR15812700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.