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NPI 1063374080ActiveIndividual· Nurse Practitioner, Gerontology· Rockford, IL

Nurse Practitioner, Gerontology with Post Acute Medical PLLC, practicing in Rockford, Illinois. Enrolled in Medicare as practitioner - nurse practitioner.

Overview

NPI1063374080
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedNov 28, 2025
Last updated in NPPESNov 28, 2025
Certified by providerNov 28, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Nurse Practitioner, Gerontology Primary363LG0600X041509622IL

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Nurse Practitioner (WI)

Medicare sources and data years

Education and affiliations

Graduation year2023
Medicare specialtyNurse Practitioner

Medical group

Source: CMS Care Compare

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

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