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General NPI Number Information
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NPI Number | 1073491346
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Entity Type | Individual
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Provider Name | MARK ANTHONY ARTABA AGNP-C
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Gender | Male
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 6841 N FRANCISCO AVE
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City | CHICAGO
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State | IL
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Zip | 60645-2927
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Country | US
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Telephone | 929-491-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 2930 N PINE GROVE AVE APT 101
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City | CHICAGO
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State | IL
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Zip | 60657-5754
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Country | US
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Telephone | 616-416-5906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209033256
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 041541036
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License Number State | IL
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