Individual provider Active NPI

Amber Brooke Potts, APRN

  • Nurse Practitioner
  • Northbrook, IL
National Provider Identifier
1962140004
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.025085 Issued in IL
Practice address
2155 Pfingsten Rd
Northbrook, IL 60062-6499
Phone
(224) 412-8220
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2023

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 209.025085 IL Primary

Addresses

Primary practice location

2155 Pfingsten Rd
Northbrook, IL 60062-6499

Mailing address

2155 Pfingsten Rd
Northbrook, IL 60062-6427
Phone (847) 366-1659

Other practice location 1

730 W Hintz Rd
Wheeling, IL 60090-5501
Phone (847) 537-7474

Other practice location 2

759 Kane St
South Elgin, IL 60177-1418
Phone (847) 697-3310

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
I20230612001237 IL Practitioner - Nurse Practitioner 4880051531 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.025085ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Top Medical Consultants PC CurrentSince Jan 28, 2023 Accepting new patients

Organizations & group practices 1

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": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1962140004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 PFINGSTEN RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626427",
            "telephone_number": "847-366-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 PFINGSTEN RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626499",
            "telephone_number": "224-412-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 W Hintz Rd",
            "address_purpose": "LOCATION",
            "city": "Wheeling",
            "state": "IL",
            "postal_code": "600905501",
            "country_code": "US",
            "telephone_number": "847-537-7474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "759 Kane St",
            "address_purpose": "LOCATION",
            "city": "South Elgin",
            "state": "IL",
            "postal_code": "601771418",
            "country_code": "US",
            "telephone_number": "847-697-3310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTS",
        "first_name": "AMBER",
        "middle_name": "BROOKE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.025085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.