MICHELENE ELLEGOOD (MSN, FNP-BC) – Family Nurse Practitioner, NPI 1174802482

MICHELENE ELLEGOOD (MSN, FNP-BC) is a healthcare provider. based in Maywood, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials MSN, FNP-BC. They hold a License No. 209008945 (IL). The NPI Number for MICHELENE ELLEGOOD (MSN, FNP-BC) is 1174802482

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
MICHELENE ELLEGOOD (MSN, FNP-BC)
NPI
1174802482
Phone
(708) 216-9000
Address
2160 S 1ST AVE
Enumeration Date
4 August 2011
Last Update Date
25 February 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3125632875
Graduation Year
2010 (16 years ago)
PAC ID
0345411864
Group Practice PAC ID
5496658874
Professional Enrollment ID
I20110913000911
Address ID
IL606125500CH1700XSTXX500
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MICHELENE ELLEGOOD (MSN, FNP-BC)

  • 2160 S 1ST AVE

    MAYWOOD, IL 601533328

    Phone: (708) 216-9000

    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: 2011-09-13

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
I20110913000911INurse 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 60153)

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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: 5496658874View full group profile
NameSpecialtyState
General SurgeryIL
Internal MedicineIL
Diagnostic RadiologyWI
Internal MedicineMI
Hematology/Oncology, Hospice/Palliative CareIL
Nurse PractitionerIL
O B S T E T R I C S/ G Y N E C O L O G YOH
Nurse PractitionerIL
Nurse PractitionerIL
O T O L A R Y N G O L O G YCT

Reviews

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Frequently asked questions

What is MICHELENE ELLEGOOD (MSN, FNP-BC)'s NPI number?
MICHELENE ELLEGOOD (MSN, FNP-BC)'s NPI is 1174802482 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to MICHELENE ELLEGOOD (MSN, FNP-BC)?
You should see MICHELENE ELLEGOOD (MSN, FNP-BC) as active in CMS-hosted NPPES data.
What expertise is attributed to MICHELENE ELLEGOOD (MSN, FNP-BC)?
MICHELENE ELLEGOOD (MSN, FNP-BC)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MICHELENE ELLEGOOD (MSN, FNP-BC) associated with Maywood?
Public fields place MICHELENE ELLEGOOD (MSN, FNP-BC) around Maywood, Illinois. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for MICHELENE ELLEGOOD (MSN, FNP-BC) is noted as August 4, 2011 where the registry provides it.

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