Individual provider Active NPI

Genti Manco

  • Family Nurse Practitioner
  • Melrose Park, IL
National Provider Identifier
1760936090
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209014660 Issued in IL
Practice address
675 W North Ave Ste 402
Melrose Park, IL 60160-1624
Phone
(708) 450-4551
NPI assigned
Aug 3, 2016
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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 209014660 IL Primary

Addresses

Primary practice location

675 W North Ave Ste 402
Melrose Park, IL 60160-1624

Mailing address

120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@nephdocs.com Direct

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
I20161017001633 IL Practitioner - Nurse Practitioner 0446548937 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Medical PLLCGroup PAC ID 5193156115, 433 clinicians
Evohome Medical CorporationGroup PAC ID 4486168515, 9 clinicians

Practice addresses (Care Compare)

101 E Via Ghiglieri
Toluca, IL 61369-9596
Phone (877) 883-9430

400 N May St
Suite 201
Chicago, IL 60642-6495
Phone (888) 491-6729

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Evohome Medical Corporation CurrentSince Oct 29, 2025 Accepting new patients
Altea Medical Illinois PLLC CurrentSince Dec 4, 2025 Accepting new patients
Post Acute Medical PLLC CurrentSince Dec 4, 2025 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

400 N May St
Ste 201
Chicago, IL 60642
Phone (888) 491-6729

490 W 16th Pl
Chicago Hts, IL 60411
Phone (708) 481-4444

3354 Jerome Ln
East Saint Louis, IL 62206
Phone (618) 337-9400

1101 E State St
Geneva, IL 60134
Phone (630) 232-7544

555 W Carpenter St
Springfield, IL 62702
Phone (217) 525-1880

101 E Via Ghiglieri
Toluca, IL 61369
Phone (815) 452-2367

Interoperability endpoints

  • Direct secure messaging: gmanco49735@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1760936090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W 22ND ST STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231563",
            "telephone_number": "630-573-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE STE 402",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601624",
            "telephone_number": "708-450-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCO",
        "first_name": "GENTI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@nephdocs.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 W 22nd St Ste 200",
            "city": "Oak Brook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605231563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.