Individual provider Active NPI

Leslie Guillermina Villalobos, NP-C

  • Family Nurse Practitioner
  • Waukegan, IL
National Provider Identifier
1902457468
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209020281 Issued in IL
Practice address
118 N Frolic Ave
Waukegan, IL 60085-4522
Phone
(847) 899-9746
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.423820 IL
Family Nurse Practitioner 363LF0000X 209020281 IL Primary

Addresses

Primary practice location

118 N Frolic Ave
Waukegan, IL 60085-4522

Mailing address

2400 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8800

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
I20200211002160 IL Practitioner - Nurse Practitioner 5496181489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of LakeGroup PAC ID 7214838861, 42 clinicians

Practice addresses (Care Compare)

2400 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8800

2410 Belvidere Rd
Waukegan, IL 60085-6165
Phone (847) 377-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.423820ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lake Current Accepting new patients
County of Lake CurrentSince Dec 22, 2019 Accepting new patients
County of Lake CurrentSince Dec 22, 2019 Accepting new patients

Locations

2400 Belvidere Rd
Waukegan, IL 60085
Phone (847) 377-8400

3010 Grand Ave
Waukegan, IL 60085
Phone (847) 377-8296

Interoperability endpoints

  • Direct secure messaging: leslie.villalobos.p1@direct.lakecountyil.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1902457468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELVIDERE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856165",
            "telephone_number": "847-377-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N FROLIC AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854522",
            "telephone_number": "847-899-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "LESLIE",
        "middle_name": "GUILLERMINA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.423820",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209020281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.