Individual provider Active NPI

Amanda M Zimmermann, APN

  • Infectious Disease Physician
  • Libertyville, IL
National Provider Identifier
1972152874
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
209019869 Issued in IL
Practice address
1870 W Winchester Rd Ste 247
Libertyville, IL 60048-5360
Phone
(847) 672-4940
NPI assigned
Sep 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 209019869 IL Primary

Addresses

Primary practice location

1870 W Winchester Rd Ste 247
Libertyville, IL 60048-5360

Mailing address

1870 W Winchester Rd Ste 247
Libertyville, IL 60048-5360
Phone (847) 672-4940

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
I20191022003806 IL Practitioner - Nurse Practitioner 1355673476 Reassigns benefits to 1 organization

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
Infectious Disease Consultants of Northern Illinois SCGroup PAC ID 4688816598, 4 clinicians

Practice addresses (Care Compare)

1870 W Winchester Rd
Suite 247
Libertyville, IL 60048-5360
Phone (847) 672-4940

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Consultants of Northern Illinois S.C. Infectious Disease CurrentSince Sep 9, 2019 Accepting new patients

Locations

1870 W Winchester Rd
Ste 247
Libertyville, IL 60048
Phone (847) 672-4940

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.

Hospital & facility affiliations 7

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": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1972152874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD STE 247",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485360",
            "telephone_number": "847-672-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 W WINCHESTER RD STE 247",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485360",
            "telephone_number": "847-672-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMANN",
        "first_name": "AMANDA",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IL",
            "license": "209019869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.