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NPI Code Detail

MEDICARE: THERESA A FLERICK N.P.

MEDICARE: THERESA A FLERICK N.P.
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 Practitioner209000506IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1209000506OTHERILLICENSE

General Provider Information

NPI Number : 1689770695
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA A FLERICK N.P.
Provider Business Mailing Address
First Line : 800 E 55TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4906
Country : US
Telephone Number : 773-702-0660
Fax Number : 773-702-4356
Provider Business Practice Location Address
First Line : 800 E 55TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4906
Country : US
Telephone Number : 773-702-0660
Fax Number : 773-702-4356
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 07/28/2021

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Directions to “ THERESA A FLERICK N.P.” Practice Location

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