Healthcare Provider Details

I. General information

NPI: 1447919410
Provider Name (Legal Business Name): MICHELLE NORRIS APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PFINGSTEN RD
GLENVIEW IL
60026-1301
US

IV. Provider business mailing address

500 MEDICAL CENTER BLVD
CONROE TX
77304-2889
US

V. Phone/Fax

Practice location:
  • Phone: 847-657-1819
  • Fax:
Mailing address:
  • Phone: 936-539-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number277005634
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1040951
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277005634
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: