Individual provider Active NPI

Megan Kosrow, APN

  • Family Nurse Practitioner
  • Elk Grove Village, IL
National Provider Identifier
1972270270
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209022978 Issued in IL
Practice address
800 Biesterfield Rd Ste 610
Elk Grove Village, IL 60007-3362
Phone
(847) 981-3630
NPI assigned
Aug 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 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 PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 209022978 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd Ste 610
Elk Grove Village, IL 60007-3362

Mailing address

800 Biesterfield Rd Ste 610
Elk Grove Village, IL 60007-3362
Phone (847) 981-3630

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address megan.kosrow.1@380.direct.athenahealth.com

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
I20210916003343 IL Practitioner - Nurse Practitioner 5092112177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

Practice addresses (Care Compare)

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Hospital & facility affiliations

  • Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
  • St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209022978ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC Single Specialty CurrentSince Sep 1, 2021 Accepting new patients

Locations

800 Biesterfield Rd
Ste 610
Elk Grove Vlg, IL 60007
Phone (847) 981-3630

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

190 W Irving Park Rd
Wood Dale, IL 60191
Phone (630) 766-0412

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 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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1972270270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 610",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "847-981-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 610",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073362",
            "telephone_number": "847-981-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSROW",
        "first_name": "MEGAN",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "megan.kosrow.1@380.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd Ste 610",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.