Individual provider Active NPI

Hanju Wang, APN-CNP

  • Nurse Practitioner
  • Long Beach, CA
National Provider Identifier
1912013012
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277001111 Issued in IL
Practice address
1220 E 4TH St
Long Beach, CA 90802-1831
Phone
(888) 530-4415
Fax
(855) 712-7837
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 277001111 IL Primary

Addresses

Primary practice location

1220 E 4TH St
Long Beach, CA 90802-1831

Mailing address

1220 E 4TH St
Long Beach, CA 90802-1831
Phone (888) 530-4415

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
I20141113000886 IL Practitioner - Nurse Practitioner 0143301168 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277001111ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake CurrentSince Sep 8, 2014 Accepting new patients
County of Lake CurrentSince Sep 8, 2014 Accepting new patients
County of Lake Current Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 7, 2022 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

731 S State Route 21
Ste 130
Gurnee, IL 60031
Phone (847) 566-3337

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

Interoperability endpoints

  • Direct secure messaging: hanju.wang.1@17371.direct.athenahealth.com

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1912013012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 E 4TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021831",
            "telephone_number": "888-530-4415",
            "fax_number": "855-712-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 4TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908021831",
            "telephone_number": "888-530-4415",
            "fax_number": "855-712-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "HANJU",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277001111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.