Healthcare Provider Details

I. General information

NPI: 1962827881
Provider Name (Legal Business Name): JANET E BURDA APRN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2014
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 WEST AVE STE 223
ORLAND PARK IL
60462-4509
US

IV. Provider business mailing address

15300 WEST AVE STE 223
ORLAND PARK IL
60462-4509
US

V. Phone/Fax

Practice location:
  • Phone: 708-923-7874
  • Fax: 708-923-7876
Mailing address:
  • Phone: 708-923-7874
  • Fax: 708-923-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number277.000593
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277000593
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: