Diesawit T. Hansom, FNP
NPI 1689391633ActiveIndividual· Nurse Practitioner, Family· Libertyville, IL
Nurse Practitioner, Family (FNP) with Lake County Immediate Care, LLC and 1 other group, practicing in Libertyville, Illinois. 46 Medicare patients in 2024, $5,013 paid; nearly all of their 89 Part D prescriptions were generic (92%). Lists Northwestern Medicine Central Dupage Hospital as a hospital affiliation.
Overview
| NPI | 1689391633 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | FNP |
| Sole proprietor | No |
| NPI issued | Oct 20, 2022 |
| Last updated in NPPES | Jun 12, 2025 |
| Certified by provider | Jun 12, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | 277.004265 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 46 |
|---|---|
| Services billed | 114 across 21 procedure codes |
| Paid by Medicare | $5,013 |
Part D prescriptions in 2024
| Prescriptions (claims) | 89 · 104 30-day fills |
|---|---|
| Patients | 65 |
| Total drug cost | $896.34 |
| Generic share | 92% of claims |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical groups
- Lake County Immediate Care, LLCHighland Park, IL · 15 clinicians
- Your Healthcare Source PLLCLibertyville, IL · 5 clinicians
Hospital affiliation
- Northwestern Medicine Central Dupage HospitalWinfield, IL
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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