Individual provider Active NPI

Alexis Manlangit Bancolita, RN, BSN

  • Registered Nurse
  • Northbrook, IL
National Provider Identifier
1508645037
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041408702 Issued in IL
Practice address
333 Pfingsten Rd
Northbrook, IL 60062-2002
Phone
(847) 272-8800
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041408702 IL Primary

Addresses

Primary practice location

333 Pfingsten Rd
Northbrook, IL 60062-2002

Mailing address

333 Pfingsten Rd
Northbrook, IL 60062-2002
Phone (847) 272-8800

Other practice location 1

2500 Lake Cook Rd
Riverwoods, IL 60015-3851
Phone (847) 451-7590

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041408702ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1508645037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 PFINGSTEN RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622002",
            "telephone_number": "847-272-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PFINGSTEN RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622002",
            "telephone_number": "847-272-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Lake Cook Rd",
            "address_purpose": "LOCATION",
            "city": "Riverwoods",
            "state": "IL",
            "postal_code": "600153851",
            "country_code": "US",
            "telephone_number": "847-451-7590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANCOLITA",
        "first_name": "ALEXIS",
        "middle_name": "MANLANGIT",
        "name_prefix": "Miss",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041408702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.