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1336873132 NPI number — ELLEN MILAD APRN

NPI Number: 1336873132
Health Care Provider/Practitioner: ELLEN MILAD APRN

Information about “1336873132” NPI (ELLEN MILAD APRN) exists in 1336873132 in HTML format HTML  |  1336873132 in plain Text format TXT  |  1336873132 in PDF (Portable Document Format) PDF  |  1336873132 in an XML format XML  formats.

NPI Number : 1336873132 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336873132",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MILAD",
    "FirstName": "ELLEN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "APRN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HUSELID",
    "OtherFirstName": "ELLEN",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "7314 OAK AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RIVER FOREST",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60305-1918",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "708-899-9395",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2160 S 1ST AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MAYWOOD",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60153-3328",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "708-327-2159",
    "PracticeLocationAddressFaxNumber": "708-327-2187",
    "EnumerationDate": "07/15/2022",
    "LastUpdateDate": "09/13/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363L00000X",
        "TaxonomyName": "Nurse Practitioner",
        "LicenseNumber": "209025493",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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