Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 209005920 | IL |
N | 363LW0102X | Nurse Practitioner - Women's Health | 209005920 | IL |
N | 363LW0102X | Nurse Practitioner - Women's Health | 71002390A | IN |
NPI | 1043677529 |
---|---|
Provider Name | Tammy Chavarria |
First Address | Oakbrook Terrace, IL 60181-4808 |
Second Address | Oakbrook Terrace, IL 60181-4808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2016 |
Last Update Date | 06/01/2021 |