Diesawit T Hansom, FNP - Medicare Nurse Practitioner in Libertyville, IL

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Diesawit T Hansom, FNP is a medicare enrolled "Nurse Practitioner - Family" in Libertyville, Illinois. Her current practice location is 1366 S Milwaukee Ave, Libertyville, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 236-0323.

Diesawit T Hansom is licensed to practice in Illinois (license number 277.004265) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1689391633.

Contact Information

Diesawit T Hansom, FNP
1366 S Milwaukee Ave,
Libertyville, IL 60048-3795
(847) 236-0323
Not Available

Map and Direction




Provider's Profile

Full NameDiesawit T Hansom
GenderFemale
SpecialityNurse Practitioner - Family
Location1366 S Milwaukee Ave, Libertyville, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1689391633
  • Provider Enumeration Date: 10/20/2022
  • Last Update Date: 06/12/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8820462849
  • Enrollment ID: I20230314002620

Medical Identifiers

Medical identifiers for Diesawit T Hansom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689391633NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 277.004265 (Illinois)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Diesawit T Hansom allows following entities to bill medicare on her behalf.
Entity NameMidwest Express Care 2 Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548692890
PECOS PAC ID: 0547495467
Enrollment ID: O20131031001375
Entity NameLake County Immediate Care, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285048975
PECOS PAC ID: 6204158280
Enrollment ID: O20141202000857
Entity NameYour Healthcare Source Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1811740046
PECOS PAC ID: 6709320526
Enrollment ID: O20240703000432

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Diesawit T Hansom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Diesawit T Hansom, FNP
1366 S Milwaukee Ave,
Libertyville, IL 60048-3795

Ph: (847) 236-0323		Diesawit T Hansom, FNP
1366 S Milwaukee Ave,
Libertyville, IL 60048-3795

Ph: (847) 236-0323

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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