Active NPI
Victoria L Mancke, APRN-BC, FNP
- Family Nurse Practitioner
- Joliet, IL
National Provider Identifier
1821103755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209005029
- Practice address
- 2025S Chicago St
Joliet, IL 60436 - Phone
- (815) 726-2200
- Fax
- (314) 536-8783
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209005029 | IL | Primary |
Addresses
Primary practice location
2025S Chicago St
Joliet, IL 60436
Mailing address
15702 W Baker Rd
Manhattan, IL 60442-9641
Phone (815) 478-4455
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
- Credentials
- Nurse Practitioner
Interoperability endpoints
- victoria.l.mancke@direct.lumeris.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1821103755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15702 W BAKER RD",
"city": "MANHATTAN",
"state": "IL",
"postal_code": "604429641",
"telephone_number": "815-478-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2025S CHICAGO ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "60436",
"telephone_number": "815-726-2200",
"fax_number": "314-536-8783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCKE",
"first_name": "VICTORIA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "APRN-BC, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209005029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.