Individual provider Active NPI

Carly Manley

  • Family Nurse Practitioner
  • Crystal Lake, IL
National Provider Identifier
1669244489
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.028716 Issued in IL
Practice address
525 E Congress Pkwy
Crystal Lake, IL 60014-6245
Phone
(815) 479-7490
Fax
(815) 455-2654
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.486742 IL
Family Nurse Practitioner 363LF0000X 209.028716 IL Primary

Addresses

Primary practice location

525 E Congress Pkwy
Crystal Lake, IL 60014-6245

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

27750 W Highway 22 Ste 240
Barrington, IL 60010-1924
Phone (847) 842-7540

Other names 1

  • Mrs. Carly Adams Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cadams287404@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20240425002504 IL Practitioner - Nurse Practitioner 3678913597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rush Medical College of Rush University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

450 W Hwy 22
Neonatology
Barrington, IL 60010-1919
Phone (847) 381-0123

Hospital & facility affiliations

  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.486742ILMDRegistered Nurse
209.028716ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corp. CurrentSince Mar 26, 2024 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 26, 2024 Accepting new patients

Locations

600 S Randall Rd
Ste 210
Algonquin, IL 60102
Phone (224) 783-4302

27750 W Il Route 22
Ste 240
Barrington, IL 60010
Phone (847) 381-5800

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

525 E Congress Pkwy
Crystal Lake, IL 60014
Phone (815) 479-7490

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1669244489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E CONGRESS PKWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146245",
            "telephone_number": "815-479-7490",
            "fax_number": "815-455-2654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27750 W Highway 22 Ste 240",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600101924",
            "country_code": "US",
            "telephone_number": "847-842-7540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANLEY",
        "first_name": "CARLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.486742",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.028716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cadams287404@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "525 E Congress Pkwy",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "525 E Congress Pkwy",
            "city": "Crystal Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600146245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "ADAMS",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.