Individual provider Active NPI

Corinna Hartwig-Mullally, APRN

  • Family Nurse Practitioner
  • Aurora, IL
National Provider Identifier
1972260727
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11210301 Issued in IL
Practice address
2020 Ogden Ave Ste 140
Aurora, IL 60504-6065
Phone
(630) 851-1144
NPI assigned
Nov 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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 F11210301 IL Primary

Addresses

Primary practice location

2020 Ogden Ave Ste 140
Aurora, IL 60504-6065

Mailing address

PO Box 446
Wasco, IL 60183-0446
Phone (928) 502-2181

Other names 1

  • Corinna Hartwig-Mullally Other name

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
I20220312000278 IL Practitioner - Nurse Practitioner 9133514003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians

Practice addresses (Care Compare)

3354 Jerome LN
Cahokia, IL 62206-2604
Phone (877) 883-9430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F11210301ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Altea Medical Illinois PLLC CurrentSince Jan 6, 2024 Accepting new patients
Post Acute Medical PLLC CurrentSince Dec 11, 2023 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

1101 E State St
Geneva, IL 60134
Phone (630) 208-1876

555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880

Organizations & group practices 2

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": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1972260727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "WASCO",
            "state": "IL",
            "postal_code": "601830446",
            "telephone_number": "928-502-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 OGDEN AVE STE 140",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605046065",
            "telephone_number": "630-851-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWIG-MULLALLY",
        "first_name": "CORINNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "F11210301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINNA",
            "last_name": "HARTWIG-MULLALLY",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.