MEDICARE: JUNE ELIZABETH OLIVER RN,APN,CNS

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	364SA2100X	Acute Care Clinical Nurse Specialist	209-002512	IL
2	367500000X	Certified Registered Nurse Anesthetist	209002512	IL
3	363L00000X	Nurse Practitioner	209002512	IL
4	163WP0000X	Pain Management Registered Nurse	209002512	IL
5	364S00000X	Clinical Nurse Specialist	209002512	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F400270461	OTHER	IL	MIEDICARE PTAN

General Provider Information

NPI Number	:	1093932436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUNE ELIZABETH OLIVER RN,APN,CNS

Provider Business Mailing Address
First Line	:	2740 W FOSTER AVE
Second Line	:	STE LL7
City	:	CHICAGO
State	:	IL
Zip	:	60625-3543
Country	:	US
Telephone Number	:	773-878-8200
Fax Number	:	176-043-2348

Provider Business Practice Location Address
First Line	:	5215 N CALIFORNIA AVE STE 600
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-8564
Country	:	US
Telephone Number	:	773-989-6222
Fax Number	:	773-989-1734

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	03/15/2021

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Directions to “ JUNE ELIZABETH OLIVER RN,APN,CNS” Practice Location

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