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General NPI Number Information
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NPI Number | 1700734365
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Entity Type | Individual
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Provider Name | AMANDA PARKER
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Gender | Female
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 2860 S RIVER RD STE 155
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City | DES PLAINES
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State | IL
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Zip | 60018-6002
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Country | US
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Telephone | 847-696-6158
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Fax |
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Provider Business Mailing Address
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Address Line | 2823 W BELMONT AVE APT 413
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City | CHICAGO
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State | IL
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Zip | 60618-5890
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Country | US
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Telephone |
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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 | 209.035032
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License Number State | IL
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