Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ajie Jibu Mammarappallil, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1215510987

Ajie Jibu Mammarappallil, AGACNP is an Acute Care Nurse Practitioner in Palos Heights, Illinois. Licensed in Illinois. Registered with an NPI since 2021.

Licensed in
IL
In the registry since
2021
Specialties on file
2

Practice location Address checks out

12251 S 80th Ave
Palos Heights, IL 60463-1290
Phone: (708) 923-4000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 209022913 (IL)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 209022913 (IL)

Record details

NPI number1215510987
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedApril 30, 2021
Last updated in NPPESApril 30, 2021
Certification dateApril 30, 2021

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