Healthcare Provider Details

I. General information

NPI: 1952640401
Provider Name (Legal Business Name): MARGARET JEANNE HORNUNG FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 E LINCOLN HWY STE 101
NEW LENOX IL
60451-1976
US

IV. Provider business mailing address

503 WESTWOOD DR
SHOREWOOD IL
60404-9429
US

V. Phone/Fax

Practice location:
  • Phone: 815-462-5545
  • Fax:
Mailing address:
  • Phone: 815-715-8763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209010194
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209010194
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: