CAROLLE M DERRADJI (NPI# 1265033385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265033385 |
| Entity Type | Individual |
| Full Name | CAROLLE M DERRADJI |
| Practice Address |
3256 W Potomac Ave Chicago IL 60651-2411 |
| Practice Telephone | 7082806164 |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.022245 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3256 W POTOMAC AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60651-2411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215474978 | Kanesha Walker Amaro | Counselor | 5910 W Division, Chicago, IL 60651 | 2017-01-19 |
| 1639628415 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 3520 West Grand, Chicago, IL 60651 | 2016-09-22 |
| 1326596321 | Giselle Tisha Wallace | Nurse's Aide | 5809 W Rice, Chgo, IL 60651 | 2016-09-19 |
| 1811385214 | Jeanette Rodriguez | Social Worker | 1116 N Kedzie Av. Office#257, Association House of Chicago, Chicago, IL 60651 | 2015-01-07 |
| 1801147475 | Diane Dickens-rogers | Massage Therapist | 5700 W. Chicago Ave., Chicago, IL 60651 | 2012-09-24 |
| 1891045241 | Association House of Chicago | Residential Treatment Facility, Emotionally Disturbed Children | 1900 North Sawyer Avenue, Chicago, IL 60651 | 2012-09-13 |
| 1770860983 | Christine C Osborne | Pharmacist | 1541 N.central Ave, Chicago, IL 60651 | 2011-11-16 |
| 1629206388 | Habilitative Systems Inc | Case Management | 1049 N Drake Ave, Chicago, IL 60651 | 2009-07-01 |
| 1841428547 | Habilitative Systems, Inc. | Case Management | 4234 W Potomac Ave, Chicago, IL 60651 | 2009-07-01 |
| 1306074000 | Habilitative Systems, Inc | Case Management | 915 N Massasoit Ave, Chicago, IL 60651 | 2009-07-01 |
| Find all providers in zip 60651 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| 1770191496 | Katherine Hickey | Nurse Practitioner | 950 W Monroe St Unit 407, Chicago, IL 60607-2795 | 2020-07-20 |
| 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.