The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Lansing and Illinois

1 active clinicians are listed under Technician/Technologist with a practice address in Lansing, IL (27 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-03-10

Technician/Technologist Primary Specialty

NUCC Taxonomy Code: 156F00000X

License # reported to NPPES IL S6B7D4F6

A broad category grouping different kinds of technologists and technicians. See individual definitions.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.

Look Up on State Board Site

Career & Practice History

NPI enumerated March 10, 2023.

No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from March 2023 to August 2026.

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NPI Administrative Meta

NPI Number: 1487355186

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 10, 2023

Last Update: March 10, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

17144 Greenbay Ave

Lansing, IL 604381332

Phone: 6304608087

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.