Mary Kay Larson, APN | |
4405 Weaver Pkwy, Warrenville, IL 60555-3269 | |
(630) 352-5450 | |
(630) 352-5499 |
Full Name | Mary Kay Larson |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 4405 Weaver Pkwy, Warrenville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124293691 | NPI | - | NPPES |
206147214 | Other | IL | MEDICARE PTAN (INDIVIDUAL) |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 209006678 (Illinois) | Primary |
Entity Name | Central Dupage Physician Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033149844 PECOS PAC ID: 5890696231 Enrollment ID: O20040303000601 |
Entity Name | Vpa Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174925663 PECOS PAC ID: 9234041948 Enrollment ID: O20040312001189 |
Entity Name | Md @ Home Illinois, Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568758415 PECOS PAC ID: 7810167830 Enrollment ID: O20110831000340 |
Mailing Address | Practice Location Address |
---|---|
Mary Kay Larson, APN 4405 Weaver Pkwy, Warrenville, IL 60555-3269 Ph: (630) 352-5450 | Mary Kay Larson, APN 4405 Weaver Pkwy, Warrenville, IL 60555-3269 Ph: (630) 352-5450 |
Carlene Porter, APN. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4405 Weaver Pkwy, Warrenville, IL 60555 Phone: 630-352-5300 Fax: 630-352-5499 | |
Laura Minarich, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 28201 Diehl Rd, Warrenville, IL 60555 Phone: 360-657-5555 | |
Carrie A Feid, APN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4405 Weaver Pkwy, Warrenville, IL 60555 Phone: 630-352-5450 Fax: 630-352-5320 | |
Mrs. Erica Souders, FNP-BC, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 28201 Diehl Rd, Warrenville, IL 60555 Phone: 708-427-5765 | |
Mr. Robert Dennis Stalley, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4405 Weaver Pkwy, Warrenville, IL 60555 Phone: 630-938-8850 Fax: 630-938-8849 | |
Jacqueline Rose Schmidt, MSN, APN, AGPCNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4405 Weaver Pkwy, Warrenville, IL 60555 Phone: 630-352-5450 Fax: 630-352-5499 |