Individual provider Active NPI

Bonnie Brownlee

  • Licensed Practical Nurse
  • South Holland, IL
National Provider Identifier
1902349376
Registry record updated Dec 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043058568 Issued in IL
Practice address
512 E 166TH PL
South Holland, IL 60473-2905
Phone
(708) 420-1195
NPI assigned
Dec 2, 2016
Last updated
Dec 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043058568 IL Primary

Addresses

Primary practice location

512 E 166TH PL
South Holland, IL 60473-2905

Mailing address

512 E 166TH PL
South Holland, IL 60473-2905
Phone (708) 420-1195

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

State licenses

LicenseStateTypeSpecialty
043058568ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480636800000",
    "number": "1902349376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 E 166TH PL",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732905",
            "telephone_number": "708-420-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 E 166TH PL",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732905",
            "telephone_number": "708-420-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWNLEE",
        "first_name": "BONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-02",
        "last_updated": "2016-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043058568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.