Sandre Leona Crain, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

209.016571 Issued in IL

Practice address

17066 S Park Ave
South Holland, IL 60473-3369

Phone

(708) 882-0532

Fax

(647) 799-2792

NPI assigned

Oct 11, 2017

Last updated

Feb 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Harvey Emergency Physicians PLLCGroup PAC ID 9436486560, 50 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Harvey Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Calumet City, IL
  • NPI 1184281651

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Tca Health Inc NFP

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1184757353

  Single Specialty

  Medicare reassignment NPD
• Crain Diagnostics PLLC

  • Health Service Clinic/Center
  • South Holland, IL
  • NPI 1740952217
  NPD Authorized official
• Tca Health Inc NFP

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1093404576

  Single Specialty

  NPD

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1770093171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281007",
            "telephone_number": "773-233-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17066 S PARK AVE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733369",
            "telephone_number": "708-882-0532",
            "fax_number": "647-799-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIN",
        "first_name": "SANDRE",
        "middle_name": "LEONA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-11",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.016571",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209.016571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Corazzi, DPT
• Cornerstone Services, Inc
• Cornerstone Services, Inc
• Nicole Margaret Couri, DDS
• Crain Diagnostics PLLC
• Debra Crockett
• CTF Illinois (ACCESS Psychological Services)
• CTF Illinois (ACCESS Behavioral Health)
• CTF Illinois (CTF Access-Supr)
• Rebecca Cummings, FNP-BC

• Primary Care Nurse Practitioner in South Holland, IL
• Providers in South Holland, IL by specialty
• Primary Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.