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General NPI Number Information
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NPI Number | 1255513743
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Entity Type | Individual
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Provider Name | ANNETTE PARKER
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Gender | Female
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 2525 S MICHIGAN AVE MEDICAL STAFF OFFICE
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City | CHICAGO
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State | IL
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Zip | 60616-2315
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Country | US
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Telephone | 312-567-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 4551 N MERRIMAC AVE
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City | CHICAGO
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State | IL
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Zip | 60630-3017
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Country | US
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Telephone | 773-283-6781
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209002952
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License Number State | IL
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