MRS. SANDRE LEONA CRAIN FNP-BC NPI 1770093171

NPI Information

  • NPI: 1770093171
  • Provider Name: MRS. SANDRE LEONA CRAIN, FNP-BC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 17066 S PARK AVE
    SOUTH HOLLAND, IL
    ZIP 60473
  • Phone: (708) 882-0532

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NPI Details

MRS. Sandre Leona Crain, FNP-BC is a primary care nurse practitioner in South Holland, IL with 8 years of experience. MRS. Sandre Leona Crain, FNP-BC NPI is 1770093171. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

17066 S PARK AVE
SOUTH HOLLAND, IL
ZIP 60473-369
Phone: (708) 882-0532
Fax: (647) 799-2792

The NPI 1770093171 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/11/2017 and was last updated on 2/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily209.016571ILLINOISNo
2363LP2300XNurse PractitionerPrimary Care209.016571ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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