=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629281621
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BARBARA ELLEN OBERG RN, APN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 880 W CENTRAL RD STE 4400
-----------------------------------------------------
City | ARLINGTON HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60005-2355
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-618-3226
-----------------------------------------------------
Fax | 847-618-3229
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 817 LOCUST DR
-----------------------------------------------------
City | SLEEPY HOLLOW
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60118-1907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-844-9930
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 364S00000X
-----------------------------------------------------
Taxonomy Name | Clinical Nurse Specialist
-----------------------------------------------------
License Number | 041-140569
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------