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General NPI Number Information
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NPI Number | 1750703104
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Entity Type | Individual
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Provider Name | KATIE PARKER APN
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Gender | Female
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Dates
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Enumeration Date | 01/18/2014
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 901 MCCLINTOCK DR STE 202
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City | BURR RIDGE
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State | IL
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Zip | 60527-0872
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Country | US
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Telephone | 630-655-6748
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Fax | 630-734-4715
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Provider Business Mailing Address
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Address Line | 901 MCCLINTOCK DR STE 201
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City | BURR RIDGE
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State | IL
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Zip | 60527-0872
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Country | US
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Telephone | 630-654-4201
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Fax | 312-279-6314
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 209011070
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License Number State | IL
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