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General NPI Number Information
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NPI Number | 1194740514
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Entity Type | Individual
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Provider Name | MARY LUDVIGSEN N.P.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 6831 NORTH AVE
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City | OAK PARK
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State | IL
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Zip | 60302-1023
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Country | US
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Telephone | 708-298-0540
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Fax |
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Provider Business Mailing Address
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Address Line | 75 REMITT DRIVE LOCKBOX 1374
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City | CHICAGO
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State | IL
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Zip | 60675-1374
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Country | US
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Telephone | 866-916-5259
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Fax | 231-922-4030
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0033192
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.003905
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704397286
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F351485
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71013806A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1467233
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License Number State | WI
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