Individual provider Active NPI

Faith Mancol

  • Physician Assistant
  • Joliet, IL
National Provider Identifier
1154076461
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-008655 Issued in IL
Practice address
951 Essington Rd
Joliet, IL 60435-8439
Phone
(815) 744-4551
Fax
(815) 744-4756
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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 085-008655 IL Primary

Addresses

Primary practice location

951 Essington Rd
Joliet, IL 60435-8439

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

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
I20220323002291 IL Practitioner - Physician Assistant 7911392295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1 S260 Summit Ave
Oakbrook Terrace, IL 60181-3941
Phone (630) 953-6600

17901 S la Grange Rd
Tinley Park, IL 60487-7226
Phone (708) 327-8300

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

2600 Compass Rd
Glenview, IL 60026-8001

300 N York Rd
Elmhurst, IL 60126-2318
Phone (630) 833-0630

675 W N Ave
Melrose Park, IL 60160-1634
Phone (708) 681-3200

6800 N Frontage Rd
Burr Ridge, IL 60527-7819
Phone (708) 327-1000

Hospital & facility affiliations

  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276
  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Mar 7, 2022 Accepting new patients
Loyola University Medical Center CurrentSince Nov 2, 2023 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Mar 7, 2022 Accepting new patients
Loyola University Medical Center CurrentSince Nov 2, 2023 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

951 Essington Rd
Joliet, IL 60435
Phone (815) 744-4551

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

675 W North Ave
Ste 214
Melrose Park, IL 60160
Phone (708) 538-5607

Organizations & group practices 5

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 3

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1154076461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 ESSINGTON RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358439",
            "telephone_number": "815-744-4551",
            "fax_number": "815-744-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCOL",
        "first_name": "FAITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-008655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.