NPIMap

Individual provider Active NPI

Leann B Young, PAC

  • Medical Physician Assistant
  • Peoria, IL
National Provider Identifier
1104835768
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085001383 Issued in IL
Practice address
8600 N Route 91
Suite 130
Peoria, IL 61615
Phone
(309) 683-5059
Fax
(309) 683-5446
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085001383 IL Primary

Addresses

Primary practice location

8600 N Route 91
Suite 130
Peoria, IL 61615

Mailing address

8600 N Route 91
Suite 130
Peoria, IL 61615
Phone (309) 683-5059

Other identifiers 4

IdentifierTypeStateIssuer
920006568OtherILRAILROAD MEDICARE
P00608470OtherILRR MEDICARE GROUP MEMBER PTAN
434110OtherILMEDICARE GROUP
CA4079OtherILRR MEDICARE GROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080612000326 IL Practitioner - Physician Assistant 0042381451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • St. Francis Medical Center Home health agency, Peoria, IL, CCN 147243
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Osf Saint Luke Medical Center Hospital, Kewanee, IL, CCN 141325
  • St Mary Medical Center Hospital, Galesburg, IL, CCN 140064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Christie Clinic, PLLC PastSince May 15, 2001 Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1104835768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 N ROUTE 91",
            "address_2": "SUITE 130",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-683-5059",
            "fax_number": "309-683-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 N ROUTE 91",
            "address_2": "SUITE 130",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-683-5059",
            "fax_number": "309-683-5446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "LEANN",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "920006568",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP MEMBER PTAN",
            "identifier": "P00608470",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "434110",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP PTAN",
            "identifier": "CA4079",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.