| Northshore Practitioners Inc | |
|
1511 Glenwood Road Glenview IL 60025-0000 | |
| (773) 935-4700 | |
| Not Available |
| Full Name | Northshore Practitioners Inc |
|---|---|
| Speciality | General Practice |
| Location | 1511 Glenwood Road, Glenview, Illinois |
| Authorized Official Name and Position | Ian Crook (PRESIDENT) |
| Authorized Official Contact | 7733010413 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Practitioners Inc 6633 N Lincoln Ave Lincolnwood IL 60712-3605 Ph: (773) 301-0413 | Northshore Practitioners Inc 1511 Glenwood Road Glenview IL 60025-0000 Ph: (773) 935-4700 |
| NPI Number | 1710289509 |
|---|---|
| Provider Enumeration Date | 11/30/2010 |
| Last Update Date | 12/07/2010 |
| Medicare PECOS PAC ID | 4385826577 |
|---|---|
| Medicare Enrollment ID | O20110309000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710289509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Nancy V Wilens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275580953 PECOS PAC ID: 2365494994 Enrollment ID: I20050617000305 |
| Provider Name | Andrea L Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629328984 PECOS PAC ID: 1355595596 Enrollment ID: I20130215000528 |
| Provider Name | Katarzyna A Koziol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710222344 PECOS PAC ID: 9234384918 Enrollment ID: I20130302000005 |
| Provider Name | Vanessa Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679133888 PECOS PAC ID: 6608101589 Enrollment ID: I20190715002603 |
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