Individual provider Active NPI

Elizabeth Faustmann, NP

  • Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1962048462
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209019733 Issued in IL
Practice address
9669 Kenton Ave Ste 608
Skokie, IL 60076-1248
Phone
(847) 677-4111
Fax
(847) 677-3343
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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 209019733 IL Primary

Addresses

Primary practice location

9669 Kenton Ave Ste 608
Skokie, IL 60076-1248

Mailing address

9735 Skokie Blvd
Skokie, IL 60077-1383
Phone (847) 380-8969

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
I20191220000328 IL Practitioner - Nurse Practitioner 1557795812 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

1420 Busse Rd
Elk Grove Village, IL 60007-5324
Phone (847) 653-0142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209019733ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Apr 19, 2021 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince Jun 10, 2024 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Apr 19, 2021 Accepting new patients

Locations

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

800 W Fulton Market
Fl 12
Chicago, IL 60607

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

1420 Busse Rd
Elk Grove Vlg, IL 60007
Phone (847) 653-0142

7425 Barrington Rd
Hanover Park, IL 60133
Phone (630) 823-0392

1840 N Richmond Rd
#M
McHenry, IL 60051

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

9735 Skokie Blvd
Skokie, IL 60077
Phone (847) 380-8969

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 4

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1962048462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771383",
            "telephone_number": "847-380-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9669 KENTON AVE STE 608",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761248",
            "telephone_number": "847-677-4111",
            "fax_number": "847-677-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSTMANN",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209019733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.