MEDICARE: PAIGE C. DENNIS DNP, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209020224	IL

General Provider Information

NPI Number	:	1053951855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE C. DENNIS DNP, FNP-BC

Provider Business Mailing Address
First Line	:	303 E WACKER DR STE 2102
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-5314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 E WACKER DR STE 2102
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-5314
Country	:	US
Telephone Number	:	224-404-0633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2020
Last Update Date	:	07/06/2023

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