Tatanisha Funches, | |
2504 Washington St Ste 102, Waukegan, IL 60085-4960 | |
(847) 623-7590 | |
(847) 623-7591 |
Full Name | Tatanisha Funches |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 2504 Washington St Ste 102, Waukegan, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336667070 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163WM0705X | Registered Nurse - Medical-surgical | 041380097 (Indiana) | Secondary |
363LF0000X | Nurse Practitioner - Family | 209029247 (Illinois) | Primary |
Entity Name | Integra Healthcare Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083000350 PECOS PAC ID: 0042539173 Enrollment ID: O20150512000922 |
Mailing Address | Practice Location Address |
---|---|
Tatanisha Funches, 125 S Wacker Dr Ste 475, Chicago, IL 60606-4438 Ph: (312) 416-3804 | Tatanisha Funches, 2504 Washington St Ste 102, Waukegan, IL 60085-4960 Ph: (847) 623-7590 |
Wendy Jahayra Miralda, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3010 Grand Ave, Waukegan, IL 60085 Phone: 847-377-8296 | |
Mercedes Rebeca Jasso, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2400 Belvidere Rd, Waukegan, IL 60085 Phone: 847-377-8800 | |
Ms. Amy Ruth Morton-miller, PHD, RN, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3010 Grand Ave, Waukegan, IL 60085 Phone: 847-377-8808 | |
Rochelle A Johnson, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3210 Grand Ave, Waukegan, IL 60085 Phone: 847-440-7339 | |
Samantha Williams, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1324 N Sheridan Rd, Waukegan, IL 60085 Phone: 847-360-3000 | |
Mrs. Antoinette Green, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1324 N Sheridan Rd, Waukegan, IL 60085 Phone: 847-360-4303 Fax: 847-596-4506 | |
Dominika Kowalski, PNP, MSN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2400 Belvidere Rd, Waukegan, IL 60085 Phone: 847-377-8400 |