Individual provider Active NPI

Manju Mary Franklin, NP

  • Family Nurse Practitioner
  • Des Plaines, IL
National Provider Identifier
1811517576
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.021150 Issued in IL
Practice address
Family Behavior Center
1455 E Golf Road, Suite 207
Desplaines, IL 60714-6071
Phone
(847) 274-2267
NPI assigned
Apr 23, 2020
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 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 209.021150 IL Primary

Addresses

Primary practice location

Family Behavior Center
1455 E Golf Road, Suite 207
Desplaines, IL 60714-6071

Mailing address

9007 N Greenwood Ave
Niles, IL 60714-1417
Phone (773) 710-6975

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.021150ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Psychiatry & Counseling, SC. Past Accepting new patients
Covenant Psychiatry PLLC PastSince Apr 26, 2020 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, 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": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1811517576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9007 N GREENWOOD AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141417",
            "telephone_number": "773-710-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FAMILY BEHAVIOR CENTER",
            "address_2": "1455 E GOLF ROAD, SUITE 207",
            "city": "DESPLAINES",
            "state": "IL",
            "postal_code": "607146071",
            "telephone_number": "847-274-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANKLIN",
        "first_name": "MANJU",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; 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.