Individual provider Active NPI

Lashonda Stockley

  • Family Nurse Practitioner
  • Bloomingdale, IL
National Provider Identifier
1104579655
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.024287 Issued in IL
Practice address
1 Tiffany PT Ste 106
Bloomingdale, IL 60108-2915
Phone
(224) 653-9507
Fax
(224) 653-9387
NPI assigned
Feb 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.024287 IL Primary

Addresses

Primary practice location

1 Tiffany PT Ste 106
Bloomingdale, IL 60108-2915

Mailing address

1 Tiffany PT Ste 106
Bloomingdale, IL 60108-2915
Phone (224) 653-9507

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
I20220524003245 IL Practitioner - Nurse Practitioner 5597142968 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.024287ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Physicians Care LLC CurrentSince Feb 10, 2022 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Apr 1, 2025 Accepting new patients
Alexandre Family Health Center LTD CurrentSince Aug 1, 2025 Accepting new patients

Locations

1 Tiffany Pt
Ste 106
Bloomingdale, IL 60108
Phone (224) 653-9507

1111 Superior St
Melrose Park, IL 60160
Phone (708) 344-2161

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 3

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": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1104579655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT STE 106",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082915",
            "telephone_number": "224-653-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT STE 106",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082915",
            "telephone_number": "224-653-9507",
            "fax_number": "224-653-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKLEY",
        "first_name": "LASHONDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.