Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 209-001273 | IL |
N | 363LA2100X | Nurse Practitioner - Acute Care | 209-001273 | IL |
NPI | 1013925239 |
---|---|
Provider Name | Diane M Rowles |
First Address | Chicago, IL 60611-3167 |
Second Address | Chicago, IL 60611-3167 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 06/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00074676 | RAILROAD MEDICARE (01) | IL |
P38244 | (02) |