Individual provider Active NPI

Ishmaella R Wilson-Mills, APN

  • Family Nurse Practitioner
  • Evergreen Park, IL
National Provider Identifier
1831676014
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018110 Issued in IL
Practice address
9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone
(708) 422-7715
Fax
(708) 422-7816
NPI assigned
Jul 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 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 209018110 IL Primary

Addresses

Primary practice location

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Other names 1

  • Ishmaella R Wilson Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address swnamd@directaddress.net Direct
Direct Messaging Address credentialing@nephdocs.com Direct

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
I20181024002109 IL Practitioner - Nurse Practitioner 2860745650 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Biesterfield Rd
Elk Grove Village, IL 60007-3372
Phone (847) 981-3680

9125 S Pulaski Rd
Evergreen Park, IL 60805-1441
Phone (708) 422-7715

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Northern Illinois, LTD. CurrentSince Dec 1, 2021 Accepting new patients
Nephrology Associates of Northern Illinois, LTD. CurrentSince Dec 1, 2021 Accepting new patients
Southwest Nephrology Associates, S.C. CurrentSince Oct 15, 2018 Accepting new patients

Locations

3223 W 63rd St
Chicago, IL 60629
Phone (773) 735-4884

800 Biesterfield Rd
Ste 104
Elk Grove Village, IL 60007
Phone (847) 593-9182

9125 S Pulaski Rd
Evergreen Pk, IL 60805
Phone (708) 422-7715

120 W 22nd St
Ste 200
Oak Brook, IL 60523
Phone (630) 575-5000

16605 107th St
Orland Park, IL 60467
Phone (708) 226-9860

Interoperability endpoints

  • Direct secure messaging: iwilsonmills19559@direct.acumenmd.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1831676014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000",
            "fax_number": "708-422-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 S PULASKI RD",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051441",
            "telephone_number": "708-422-7715",
            "fax_number": "708-422-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON-MILLS",
        "first_name": "ISHMAELLA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swnamd@directaddress.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9125 S Pulaski Rd",
            "city": "Evergreen Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "608051441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ISHMAELLA",
            "last_name": "WILSON",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.