Individual provider Active NPI

Tricia Mann

  • Family Nurse Practitioner
  • Willowbrook, IL
National Provider Identifier
1376297002
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024711 Issued in IL
Practice address
40 75TH St
Willowbrook, IL 60527-2325
Phone
(630) 581-5372
Fax
(630) 568-3247
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 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 209024711 IL Primary

Addresses

Primary practice location

40 75TH St
Willowbrook, IL 60527-2325

Mailing address

5912 Sherman Ave
Downers Grove, IL 60516-1766
Phone (630) 484-4446

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
I20220324002993 IL Practitioner - Nurse Practitioner 4183019342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Express Care 2, IncGroup PAC ID 0547495467, 221 clinicians

Practice addresses (Care Compare)

157 E Boughton Rd
Bolingbrook, IL 60440-2060
Phone (630) 326-7981

17126 Harlem Ave
Tinley Park, IL 60477-3504
Phone (331) 481-5048

1720 N Orchard Rd
Aurora, IL 60506-6447
Phone (331) 282-2016

1910 E Roosevelt Rd
Wheaton, IL 60187-6955
Phone (331) 866-1013

3258 W 111TH St
Chicago, IL 60655-2729
Phone (773) 629-8217

3314 S Cicero Ave
Cicero, IL 60804-4531
Phone (708) 656-3831

40 75TH St
Willowbrook, IL 60527-2325
Phone (630) 581-5372

6320 S Cass Ave
Westmont, IL 60559-3207
Phone (331) 481-6869

7786 S Cicero Ave
Burbank, IL 60459-1583
Phone (708) 425-3085

865 E Geneva Rd
Carol Stream, IL 60188-2807
Phone (630) 320-6117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Feb 11, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Feb 11, 2022 Accepting new patients

Locations

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1376297002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 SHERMAN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605161766",
            "telephone_number": "630-484-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 75TH ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272325",
            "telephone_number": "630-581-5372",
            "fax_number": "630-568-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "TRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

Verify at the official NPI Registry.