Healthcare Provider Details

I. General information

NPI: 1407906126
Provider Name (Legal Business Name): CATHY JO ADAMSON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHY JO IRELAND

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E BRUSH HILL RD STE 202
ELMHURST IL
60126-5661
US

IV. Provider business mailing address

133 E BRUSH HILL RD STE 202
ELMHURST IL
60126-5661
US

V. Phone/Fax

Practice location:
  • Phone: 331-231-6200
  • Fax: 331-231-6201
Mailing address:
  • Phone: 331-231-6200
  • Fax: 331-231-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number277.000637
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209001646
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: