Individual provider Active NPI

Alpha Jarosz, FNP

  • Family Nurse Practitioner
  • Libertyville, IL
National Provider Identifier
1932479847
Registry record updated Sep 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009332 Issued in IL
Practice address
333 Peterson Rd Ste 240
Libertyville, IL 60048-1085
Phone
(224) 864-2124
Fax
(224) 246-8125
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 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 209009332 IL Primary

Addresses

Primary practice location

333 Peterson Rd Ste 240
Libertyville, IL 60048-1085

Mailing address

17942 W Pond Ridge Cir
Gurnee, IL 60031-4534

Other practice location 1

2504 Washington St Ste 401C
Waukegan, IL 60085-4960
Phone (224) 864-2124

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
I20120613000341 IL Practitioner - Nurse Practitioner 0143415125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

333 Peterson Rd
Suite 240
Libertyville, IL 60048-1085
Phone (224) 864-2124

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209009332ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Karefirst Illinois PC Past Accepting new patients
Mainstay Clinics Inc PastSince Sep 10, 2023 Accepting new patients

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694217600000",
    "number": "1932479847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17942 W POND RIDGE CIR",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PETERSON RD STE 240",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481085",
            "telephone_number": "224-864-2124",
            "fax_number": "224-246-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2504 Washington St Ste 401C",
            "address_purpose": "LOCATION",
            "city": "Waukegan",
            "state": "IL",
            "postal_code": "600854960",
            "country_code": "US",
            "telephone_number": "224-864-2124",
            "fax_number": "224-246-8125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAROSZ",
        "first_name": "ALPHA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2023-09-09",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.