Individual provider Active NPI

Lauren Jeanne Mann, PA-C

  • Physician Assistant
  • Evanston, IL
National Provider Identifier
1104502855
Registry record updated Apr 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.011202 Issued in IL
Practice address
1723 Howard St
Evanston, IL 60202-3735
Phone
(224) 307-8550
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.011202 IL Primary

Addresses

Primary practice location

1723 Howard St
Evanston, IL 60202-3735

Mailing address

14101 Ellison Ave
Omaha, NE 68164-5121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250806002639 IL Practitioner - Physician Assistant 5395253652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085.011202ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince Jun 9, 2025 Accepting new patients

Locations

600 W Fulton St
Ste 300
Chicago, IL 60661

1723 Howard St
Evanston, IL 60202
Phone (224) 307-8550

Interoperability endpoints

  • Direct secure messaging: lmann27572@direct.achn.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745712000000",
    "number": "1104502855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 ELLISON AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681645121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 HOWARD ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023735",
            "telephone_number": "224-307-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "LAUREN",
        "middle_name": "JEANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-04-27",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.011202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.