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NPI Code Detail

MEDICARE: TONYA COSBY FNP-C

MEDICARE:   TONYA  COSBY  FNP-C
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
1363LF0000XFamily Nurse Practitioner209.016092IL

General Provider Information

NPI Number : 1134642770
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYA COSBY FNP-C
Provider Business Mailing Address
First Line : 4717 S GREENWOOD AVE UNIT G
Second Line :
City : CHICAGO
State : IL
Zip : 60615-1933
Country : US
Telephone Number : 773-941-2717
Fax Number :
Provider Business Practice Location Address
First Line : 4717 S GREENWOOD AVE UNIT G
Second Line :
City : CHICAGO
State : IL
Zip : 60615-1933
Country : US
Telephone Number : 773-941-2717
Fax Number : 773-941-2717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2017
Last Update Date : 07/25/2017

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Directions to “ TONYA COSBY FNP-C” Practice Location

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