MEDICARE: TEIA L ATWOOD NP-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
1	207RI0200X	Infectious Disease Physician	209.007896	IL
2	363LA2200X	Adult Health Nurse Practitioner	209.007896	IL

General Provider Information

NPI Number	:	1205165222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEIA L ATWOOD NP-C

Provider Business Mailing Address
First Line	:	5250 OLD ORCHARD RD STE 300
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-4462
Country	:	US
Telephone Number	:	847-920-0902
Fax Number	:	847-920-0901

Provider Business Practice Location Address
First Line	:	5250 OLD ORCHARD RD STE 300
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077
Country	:	US
Telephone Number	:	847-920-0902
Fax Number	:	847-920-0901

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

Provider Enumeration Date	:	12/22/2009
Last Update Date	:	03/12/2026

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