Mrs Terrah Koppie Gavrilos, APN, CNP | |
925 Sherwood Dr, Lake Bluff, IL 60044-2203 | |
(847) 234-1177 | |
(847) 234-1875 |
Full Name | Mrs Terrah Koppie Gavrilos |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 9 Years |
Location | 925 Sherwood Dr, Lake Bluff, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396250346 | NPI | - | NPPES |
309010634 | Other | IL | APN CONTROLLED SUBSTANCE |
209105215 | Other | IL | APN |
041374819 | Other | IL | REGISTERED PROFESSIONAL NURSE |
1396250346 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0200X | Nurse Practitioner - Pediatrics | 209015215 (Illinois) | Secondary |
363LF0000X | Nurse Practitioner - Family | 209015215 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Pinnacle Dermatology Sc | 8628353380 | 144 |
Entity Name | Northwestern Medical Faculty Foundation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541 |
Entity Name | Tripti Burt Plastic Surgery Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487846580 PECOS PAC ID: 4688638349 Enrollment ID: O20041112001121 |
Entity Name | Pinnacle Dermatology Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861930984 PECOS PAC ID: 8628353380 Enrollment ID: O20170320000738 |
Mailing Address | Practice Location Address |
---|---|
Mrs Terrah Koppie Gavrilos, APN, CNP 261 E Drury Ln, North Barrington, IL 60010-2111 Ph: (229) 415-1203 | Mrs Terrah Koppie Gavrilos, APN, CNP 925 Sherwood Dr, Lake Bluff, IL 60044-2203 Ph: (847) 234-1177 |
Therese Ann Hejazinia, APN, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 917 Sherwood Dr Ste 200, Lake Bluff, IL 60044 Phone: 847-232-3447 Fax: 224-678-0001 | |
Ms. Susan C Deney, A.P.N. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 101 Waukegan Rd, Suite 1200, Lake Bluff, IL 60044 Phone: 847-295-8500 Fax: 847-295-8501 | |
Michael Ficaro, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 900 North Shore Dr Ste 120, Lake Bluff, IL 60044 Phone: 847-615-1698 | |
Caitlin M Mcenerney, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 71 Waukegan Rd, Lake Bluff, IL 60044 Phone: 847-295-8500 | |
Ashley Nicole Juntunen, DNP, APRN, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 917 Sherwood Dr Ste 100, Lake Bluff, IL 60044 Phone: 847-295-1220 Fax: 847-295-1255 |