Individual provider Active NPI

Leslie Faye Mann, LPN

  • Licensed Practical Nurse
  • Crystal Lake, IL
National Provider Identifier
1477742468
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
Practice address
440 S McHenry Ave
Crystal Lake, IL 60014-7147
Phone
(815) 356-8773
Fax
(815) 356-9100
NPI assigned
Oct 16, 2007
Last updated
Oct 16, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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 IL Primary

Addresses

Primary practice location

440 S McHenry Ave
Crystal Lake, IL 60014-7147

Mailing address

1670 Mulberry LN
Apt C
Elgin, IL 60123-7045

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
043060352ILMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Amidei Nursing Registry Inc Past Accepting new patients

Organizations & group practices 1

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1477742468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 MULBERRY LN",
            "address_2": "APT C",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S MCHENRY AVE",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147147",
            "telephone_number": "815-356-8773",
            "fax_number": "815-356-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "LESLIE",
        "middle_name": "FAYE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.