Healthcare Provider Details

I. General information

NPI: 1508263237
Provider Name (Legal Business Name): CAROLINE EDELMANN RN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 N OAKLEY BLVD # 3
CHICAGO IL
60622-4856
US

IV. Provider business mailing address

932 N OAKLEY BLVD # 3
CHICAGO IL
60622-4856
US

V. Phone/Fax

Practice location:
  • Phone: 847-977-2580
  • Fax:
Mailing address:
  • Phone: 847-977-2580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number041419655
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberEDE104385869
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: