NPIMap

Organization Active NPI

Frontier Healthcare Systems of Illinois LLC

  • Family Nurse Practitioner
  • Olympia Fields, IL
National Provider Identifier
1053772020
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FRONTIER HEALTHCARE SYSTEMS OF ILLINOIS LLC
Practice address
20280 Governors Hwy Ste 102
Olympia Fields, IL 60461-1068
Phone
(708) 234-0388
Fax
(708) 234-0394
NPI assigned
Mar 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Letasha Lewis, APNNPI 1033476080
Title
Owner
Phone
(901) 283-4011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Pain Clinic/Center 261QP3300X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

20280 Governors Hwy Ste 102
Olympia Fields, IL 60461-1068

Mailing address

900 Ogden Ave # 335
Downers Grove, IL 60515-2829
Phone (708) 234-0388

Other identifiers 1

IdentifierTypeStateIssuer
277001315MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160415001926 IL Part B Supplier - Clinic/Group Practice 7214235779 Receives reassigned benefits from 7 practitioners
Practice locations: Downers Grove, IL

National Provider Directory

National Provider Directory
Tax ID family
Frontier Healthcare Systems2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11700 S Western Ave
Chicago, IL 60643

20280 Governors Hwy
Ste 102
Olympia Fields, IL 60461
Phone (708) 234-0388

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1053772020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 OGDEN AVE # 335",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152829",
            "telephone_number": "708-234-0388",
            "fax_number": "708-234-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20280 GOVERNORS HWY STE 102",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611068",
            "telephone_number": "708-234-0388",
            "fax_number": "708-234-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER HEALTHCARE SYSTEMS OF ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "LETASHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-283-4011",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277001315",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.