Individual provider Active NPI

Anne Rowena Manalang, FNP

  • Family Nurse Practitioner
  • Aurora, IL
National Provider Identifier
1669814364
Registry record updated Jul 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209010369 Issued in IL
Practice address
2116 W Galena Blvd
Suite 112
Aurora, IL 60506-3533
Phone
(630) 897-1895
Fax
(630) 897-2043
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2019

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 209010369 IL Primary

Addresses

Primary practice location

2116 W Galena Blvd
Suite 112
Aurora, IL 60506-3533

Mailing address

742 Essington Rd
Joliet, IL 60435-4912
Phone (630) 897-1895

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
209010369ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olson Chiropractic, Inc. PastSince Nov 1, 2006 Accepting new patients
Pure Health Physical Medicine, LLC Family PastSince Mar 11, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564272000000",
    "number": "1669814364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 ESSINGTON RD",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604354912",
            "telephone_number": "630-897-1895",
            "fax_number": "630-897-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 W GALENA BLVD",
            "address_2": "SUITE 112",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605063533",
            "telephone_number": "630-897-1895",
            "fax_number": "630-897-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALANG",
        "first_name": "ANNE",
        "middle_name": "ROWENA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2019-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2019; 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.