=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144030362
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CASSANDRA JEAN CHAPLINSKI MSN, APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2025
-----------------------------------------------------
Last Update Date | 11/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 E FAIRMAN AVE
-----------------------------------------------------
City | WATSEKA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60970-1644
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-432-5411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 235 S WABASH AVE
-----------------------------------------------------
City | BRADLEY
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60915-2229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-329-0597
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 209031349
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------