Individual provider Active NPI

Leslie Duntemann, LSW

  • Social Worker
  • Peru, IL
National Provider Identifier
1326597345
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.101801 Issued in IL
Practice address
4461 Progress Blvd
Peru, IL 61354-1109
Phone
(815) 223-9678
NPI assigned
Oct 3, 2016
Last updated
Oct 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.101801 IL Primary

Addresses

Primary practice location

4461 Progress Blvd
Peru, IL 61354-1109

Mailing address

4461 Progress Blvd
Peru, IL 61354-1109
Phone (815) 223-9678

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
150.101801ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1326597345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4461 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541109",
            "telephone_number": "815-223-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4461 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541109",
            "telephone_number": "815-223-9678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNTEMANN",
        "first_name": "LESLIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.101801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.