Healthcare Provider Details

I. General information

NPI: 1386009686
Provider Name (Legal Business Name): AUSRA SIMMERT APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2015
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16519 S ROUTE 59 STE 1
PLAINFIELD IL
60586-2607
US

IV. Provider business mailing address

8345 OLD RIDGE RD
PLAINFIELD IL
60544-9134
US

V. Phone/Fax

Practice location:
  • Phone: 630-646-5020
  • Fax: 630-646-5025
Mailing address:
  • Phone: 708-912-5479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277001485
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277001485
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: