MEDICARE: AMANDA PARKER

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	209.035032	IL

General Provider Information

NPI Number	:	1700734365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA PARKER

Provider Business Mailing Address
First Line	:	2823 W BELMONT AVE APT 413
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-5890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 S RIVER RD STE 155
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-6002
Country	:	US
Telephone Number	:	847-696-6158
Fax Number	:

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

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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Directions to “ AMANDA PARKER ” Practice Location

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