Active NPI
Ebony Lucas
- Home Health Aide
- Lansing, IL
National Provider Identifier
1669129722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 22020493626L
- Practice address
- 3007 Bernice Rd
Lansing, IL 60438-1243 - Phone
- (312) 826-6277
- NPI assigned
- Mar 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 22020493626L | IL | Primary |
Addresses
Primary practice location
3007 Bernice Rd
Lansing, IL 60438-1243
Mailing address
3007 Bernice Rd
Lansing, IL 60438-1243
Phone (312) 826-6277
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | laptop |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22020493626L | IL | MD | Home Health Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646697600000",
"number": "1669129722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3007 BERNICE RD",
"city": "LANSING",
"state": "IL",
"postal_code": "604381243",
"telephone_number": "312-826-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3007 BERNICE RD",
"city": "LANSING",
"state": "IL",
"postal_code": "604381243",
"telephone_number": "312-826-6277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "EBONY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-08",
"last_updated": "2022-03-08",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "IL",
"license": "22020493626L",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "laptop",
"affiliation": "N",
"address_1": "3007 Bernice Rd",
"city": "Lansing",
"state": "IL",
"country_code": "US",
"postal_code": "604381243",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lansing, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.