Individual provider Active NPI

Mandy Lusung, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oak Brook, IL
National Provider Identifier
1992403760
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209026954 Issued in IL
Practice address
1200 Harger Rd Ste 200
Oak Brook, IL 60523-1816
Phone
(630) 607-0387
NPI assigned
Feb 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026954 IL Primary

Addresses

Primary practice location

1200 Harger Rd Ste 200
Oak Brook, IL 60523-1816

Mailing address

1200 Harger Rd Ste 200
Oak Brook, IL 60523-1816
Phone (630) 607-0387

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
I20230815002298 IL Practitioner - Nurse Practitioner 7416319967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Advanced Psychiatric Solutions, IncGroup PAC ID 9638535354, 25 clinicians

Practice addresses (Care Compare)

1200 Harger Rd
Suite 200
Oak Brook, IL 60523-1816
Phone (630) 607-0387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Psychiatric Solutions Inc. CurrentSince Jul 2, 2023 Accepting new patients
MD Medical, LLC PastSince Jun 3, 2026 Accepting new patients

Locations

1721 Moon Lake Blvd
Ste 201
Hoffman Estates, IL 60169
Phone (630) 607-0387

377 E Butterfield Rd
Ste 230
Lombard, IL 60148

1284 Rickert Dr
Ste 200
Naperville, IL 60540
Phone (630) 607-0387

1200 Harger Rd
Ste 200
Oak Brook, IL 60523
Phone (630) 556-8914

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1992403760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231816",
            "telephone_number": "630-607-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HARGER RD STE 200",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231816",
            "telephone_number": "630-607-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSUNG",
        "first_name": "MANDY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209026954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

Verify at the official NPI Registry.