Individual provider Active NPI

Elena Kathleen McMillin, LPN

  • Licensed Practical Nurse
  • Marion, IL
National Provider Identifier
1285153254
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043.118179 Issued in IL
Practice address
11531 Sunderland Rd
Marion, IL 62959-8274
Phone
(618) 964-5139
NPI assigned
Sep 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043.118179 IL Primary

Addresses

Primary practice location

11531 Sunderland Rd
Marion, IL 62959-8274

Mailing address

318 W Market St
Farmer City, IL 61842-1430
Phone (618) 559-3364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043.118179ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505088000000",
    "number": "1285153254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 W MARKET ST",
            "city": "FARMER CITY",
            "state": "IL",
            "postal_code": "618421430",
            "telephone_number": "618-559-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11531 SUNDERLAND RD",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629598274",
            "telephone_number": "618-964-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLIN",
        "first_name": "ELENA",
        "middle_name": "KATHLEEN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.118179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.