Mary Komperda, APN | |
675 W North Ave, Ste-210, Melrose Park, IL 60160-1634 | |
(708) 450-5094 | |
(708) 344-0508 |
Full Name | Mary Komperda |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Adult Health |
Location | 675 W North Ave, Melrose Park, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881640902 | NPI | - | NPPES |
209712 | Other | IL | MEDICARE GROUP NUMBER |
31602469 | Other | IL | BLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER |
P00236752 | Other | IL | RAILROAD MEDICARE INDIVIDUAL PROVIDER ID |
1164530713 | Other | IL | CONSULTANTS IN CARDIOVASCULAR MEDICINE, S.C. GROUP NPI NUMBER |
961280 | Other | IL | MEDICARE GROUP NUMBER |
CC1592 | Other | IL | RAILROAD MEDICARE GROUP PTAN NUMBER |
K18549 | Other | IL | MEDICARE INDIVIDUAL PTAN NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LA2200X | Nurse Practitioner - Adult Health | 209-004003 (Illinois) | Primary |
Entity Name | Community Care Health Network Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619368842 PECOS PAC ID: 8527324151 Enrollment ID: O20210414000501 |
Mailing Address | Practice Location Address |
---|---|
Mary Komperda, APN 675 W North Ave, Suite 210, Melrose Park, IL 60160-1634 Ph: (708) 450-5094 | Mary Komperda, APN 675 W North Ave, Ste-210, Melrose Park, IL 60160-1634 Ph: (708) 450-5094 |
Priyaben N Patel, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3006 Pearl Ave, Melrose Park, IL 60164 Phone: 630-518-5610 | |
Mrs. Elisabeth Janette Miwa, MSN, APRN, AGNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 719 W North Ave, Melrose Park, IL 60160 Phone: 888-584-7888 | |
Fabiola Adriana Nava-lopez, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 701 W North Ave, Melrose Park, IL 60160 Phone: 708-681-3200 | |
Kimberly Nicole Stanford, CRNA Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 701 W North Ave, Anesthesia Department, Melrose Park, IL 60160 Phone: 708-681-7859 | |
Olukemi Aina, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1414 Main St, Melrose Park, IL 60160 Phone: 708-410-0615 | |
Sarena Richardson, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 153 1/2 Broadway St, Melrose Park, IL 60160 Phone: 708-345-8960 | |
Emily Casselbury, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1111 Superior St, Suite 104, Melrose Park, IL 60160 Phone: 708-486-2700 Fax: 708-486-2702 |