Healthcare Provider Details

I. General information

NPI: 1154789964
Provider Name (Legal Business Name): MARIA ARLENE J SAXSMA FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIE ARLENE JAKOSALEM

II. Dates (important events)

Enumeration Date: 02/08/2016
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 E PALATINE RD
PALATINE IL
60074-5551
US

IV. Provider business mailing address

1990 LARKIN AVE STE 3
ELGIN IL
60123-5827
US

V. Phone/Fax

Practice location:
  • Phone: 847-776-1400
  • Fax: 847-776-1424
Mailing address:
  • Phone: 847-289-5727
  • Fax: 847-888-5469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-013370
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: