Individual provider Active NPI

Amanda J Lemay, FNP-C

  • Family Nurse Practitioner
  • Joliet, IL
National Provider Identifier
1790390797
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209021746 Issued in IL
Practice address
1106 Neal Ave
Joliet, IL 60433-2548
Phone
(815) 727-8670
NPI assigned
Sep 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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 209021746 IL Primary

Addresses

Primary practice location

1106 Neal Ave
Joliet, IL 60433-2548

Mailing address

12964 Bradford LN
Plainfield, IL 60585-2106
Phone (630) 697-2146

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
I20210407001514 IL Practitioner - Nurse Practitioner 2860809985 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209021746ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Will County Community Health Center CurrentSince Dec 1, 2020 Accepting new patients
Ellis Chiropractic Inc. CurrentSince Mar 16, 2024 Accepting new patients
Will County Community Health Center CurrentSince Dec 1, 2020 Accepting new patients
Proactive Wellness Group CurrentSince Mar 16, 2024 Accepting new patients

Locations

391 Quadrangle Dr
Ste 130
Bolingbrook, IL 60440
Phone (630) 679-7000

501 Ella Ave
Joliet, IL 60433
Phone (815) 727-8480

1106 Neal Ave
Joliet, IL 60433
Phone (815) 727-5054

805 W Jefferson St
Ste A
Shorewood, IL 60404
Phone (815) 725-8660

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1790390797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12964 BRADFORD LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605852106",
            "telephone_number": "630-697-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 NEAL AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604332548",
            "telephone_number": "815-727-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMAY",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.