AMANDA MAE ST LOUIS (FNP-C) – Family Nurse Practitioner, NPI 1124800966

AMANDA MAE ST LOUIS (FNP-C) is a healthcare provider. based in Elgin, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. F10230648 (IL). The NPI Number for AMANDA MAE ST LOUIS (FNP-C) is 1124800966

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA MAE ST LOUIS (FNP-C)
NPI
1124800966
Phone
(224) 760-7322
Address
1530 N RANDALL RD STE 210
Enumeration Date
17 October 2023
Last Update Date
17 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8157445560
Graduation Year
2023 (3 years ago)
PAC ID
7810347325
Group Practice PAC ID
4688039209
Professional Enrollment ID
I20231226001158
Address ID
IL604356698JO306XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for AMANDA MAE ST LOUIS (FNP-C)

  • 1530 N RANDALL RD STE 210

    ELGIN, IL 601237879

    Phone: (224) 760-7322

    Fax: (224) 535-8252

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231226001158INurse PractitionerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60123)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688039209View full group profile
NameSpecialtyState
Mental Health CounselorIL
Clinical Social WorkerIL
Nurse PractitionerIL
Nurse PractitionerIL
Clinical Social WorkerIL
Nurse PractitionerIL
Mental Health CounselorIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

What federal number belongs to AMANDA MAE ST LOUIS (FNP-C)?
The federal identifier for AMANDA MAE ST LOUIS (FNP-C) is NPI 1124800966.
Does this profile mean AMANDA MAE ST LOUIS (FNP-C) is currently active?
Yes — AMANDA MAE ST LOUIS (FNP-C) appears active in the national provider directory.
Does AMANDA MAE ST LOUIS (FNP-C) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for AMANDA MAE ST LOUIS (FNP-C). Clinical services aligned with this taxonomy classification.
What location shows for AMANDA MAE ST LOUIS (FNP-C)?
We surface Elgin, Illinois for AMANDA MAE ST LOUIS (FNP-C) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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