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General NPI Number Information
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NPI Number | 1578817003
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Entity Type | Individual
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Provider Name | IRMA E FUNES ANP
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Gender | Female
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | 8950 GROSS POINT RD STE. 300
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City | SKOKIE
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State | IL
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Zip | 60077-1886
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Country | US
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Telephone | 847-965-1901
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Fax | 847-965-1952
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Provider Business Mailing Address
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Address Line | 5341 CAROL ST
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City | SKOKIE
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State | IL
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Zip | 60077-2002
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Country | US
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Telephone | 847-965-1901
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Fax | 847-965-1952
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209-009925
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209009925
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License Number State | IL
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