MARGUERITE A WYDRA (NPI# 1255694568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255694568 |
| Entity Type | Individual |
| Full Name | MARGUERITE A WYDRA |
| Practice Address |
1653 W. Congress Pkwy 622 Murdock Chicago IL 60612 |
| Practice Telephone | 3129426194 |
| Practice Fax Number | 3129424370 |
| Mailing Telephone | 3129426194 |
| Mailing Fax Number | 3129424370 |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
209-008510 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1653 W. CONGRESS PKWY 622 MURDOCK |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245451905 | Jay Matthew Behel | Psychologist | 1653 W. Congress Pkwy, Chicago, IL 60612-3833 | 2007-05-01 |
| 1609397645 | Victor Nwankwo | Student in an Organized Health Care Education/Training Program | 1653 W. Congress Pkwy, Chicago, IL 60612 | 2017-06-29 |
| 1336679299 | Stephen W. Sawyer Jr. | Internal Medicine | 1653 W. Congress Pkwy, Rush University Medical Center, Chicago, IL 60612 | 2017-06-14 |
| 1235395567 | Darlene Recker | Anesthesiology | 1653 W. Congress Pkwy, Dpt of Anesthesiology, Jelke 7, Chicago, IL 60612-3833 | 2008-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760646962 | Thelma P. Reed | Clinical Nurse Specialist | 326 .west 64th St., Suite 412, Chicago, IL 60621-1334 | 2008-07-16 |
| 1871711283 | Jeannine Marie Cheatham | Clinical Nurse Specialist | 5841 S Maryland Ave # Mc4064, Room C146, Chicago, IL 60637-1447 | 2007-04-23 |
| 1578649372 | Renee C.b. Manworren | Clinical Nurse Specialist | 225 E. Chicago Avenue, Box 47, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611-2991 | 2006-10-27 |
| 1679594014 | Therese Nancy Coha | Clinical Nurse Specialist | 2300 N Childrens Plz # 63, Chicago, IL 60614-3363 | 2006-07-21 |
| 1508381161 | Nicholette M Andrews | Clinical Nurse Specialist | 355 E Erie St, Chicago, IL 60611-3167 | 2017-08-04 |
| 1043684533 | Gabriel Campos | Clinical Nurse Specialist | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2015-11-20 |
| 1376937474 | Rona Tiglao | Clinical Nurse Specialist | 1725 W Harrison St, Suite 710, Chicago, IL 60612-3841 | 2015-03-26 |
| 1922402387 | Bridget Mccarthy | Clinical Nurse Specialist | 225 E Chicago Ave, Chicago, IL 60611-2991 | 2014-10-14 |
| 1588956627 | Monica Gonzalez | Clinical Nurse Specialist | 5721 S Maryland Ave, Chicago, IL 60637-1425 | 2011-05-09 |
| 1083646467 | Joyce Ann Weishaar | Clinical Nurse Specialist | 2300 N Childrens Plz, Chicago, IL 60614-3363 | 2006-07-07 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.