Healthcare Provider Details

I. General information

NPI: 1649760901
Provider Name (Legal Business Name): ERIN MARIE HURLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD STE 407
WINFIELD IL
60190-1379
US

IV. Provider business mailing address

25 N WINFIELD RD STE 407
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 312-694-7337
  • Fax: 630-938-4416
Mailing address:
  • Phone: 312-694-7337
  • Fax: 630-938-4416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085012230
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberPA56141
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: