Maryann Ebom, DNP, PMHNP, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F10201531 Issued in IL

Practice address

18225 Burnham Ave
Lansing, IL 60438-3059

Phone

(708) 957-3101

Fax

(708) 991-2253

NPI assigned

Nov 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Divine Touch Cila Homes Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Homewood, IL
  • NPI 1326541970
  NPD Authorized official
• Living Spring Home Healthcare Inc

  • Home Health Agency
  • Flossmoor, IL
  • NPI 1003050097
  NPD Authorized official

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1922601889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 186TH ST",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302798",
            "telephone_number": "708-957-3101",
            "fax_number": "708-991-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18225 BURNHAM AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383059",
            "telephone_number": "708-957-3101",
            "fax_number": "708-991-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBOM",
        "first_name": "MARYANN",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F10201531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhiannon Amber Duran, CCC-SLP/L
• Danae Durham
• Timothy K Durnin, D.C.
• Eagle Optical, Inc.
• Eagle Optical, Inc.
• Donna Edmonson
• Tiffany Gae Edwards
• Elaris Home Care Service LLC
• Elaris Home Services LLC
• Miguel Angel Esquinca, DC

• Family Nurse Practitioner in Lansing, IL
• Providers in Lansing, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.