Prestige Aesthetics and Hydration Lounge
NPI 1720774938ActiveOrganization· Nurse Practitioner, Family· Gurnee, IL
Nurse Practitioner, Family in Gurnee, Illinois, registered in NPPES in April 2023. The authorized official on file is Diesawit T. Hansom, FNP, Fnp.
Overview
| NPI | 1720774938 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 12, 2023 |
| Last updated in NPPES | Jun 12, 2023 |
| Certified by provider | Jun 12, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Nurse Practitioner, Family providers in Gurnee
- 1215318555
- 1356121487
- 1255925236
- 1568952612
- 1437651072
- 1891568531
- 1235887779
- 1699250258
- 1972407559
- 1487343729
- 1720604713
- 1326591306