Frontier Healthcare Systems Of Illinois LLC
Nurse Practitioner, Family in Olympia Fields, IL. Organization (NPI-2).
NPI number1053772020
StatusActive
Last updated in NPPESApr 21, 2026
Details
- NPI
- 1053772020
- Entity type
- Organization (NPI-2)
- Legal business name
- Frontier Healthcare Systems Of Illinois LLC
- Organization subpart
- No
- Enumeration date
- Mar 17, 2016
- Certification date
- Apr 21, 2026
- Last updated
- Apr 21, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 261QP3300X | Clinic/Center, Pain | – | – |
Practice location
20280 Governors Hwy Ste 102Olympia Fields, IL 60461-1068
Phone 708-234-0388 · Fax 708-234-0394
Mailing address
900 Ogden Ave # 335Downers Grove, IL 60515-2829
Phone 708-234-0388 · Fax 708-234-0394
Authorized official
Letasha Lewis
Owner
9012834011
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