NANCY RENEE PROKUP (NPI# 1306155072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306155072 |
| Entity Type | Individual |
| Full Name | NANCY RENEE PROKUP |
| Credential | CNP |
| Practice Address |
360 Station Dr Crystal Lake IL 60014 |
| Mailing Address |
360 Station Dr Crystal Lake IL 60014-7978 |
| Practice Telephone | 8153386600 |
| Practice Fax Number | 8154558044 |
| Mailing Telephone | 8153386600 |
| Mailing Fax Number | 8154558044 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2019-03-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209008330 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE LICENSE | 209008330 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10350 Haligus Rd, Huntley, IL 601429545 | 8153386600 | 8478027112 |
| 1480 Center Rd, Suite A, Avon, OH 440111239 | 4409374600 | 4409374605 |
| 1925 Huntley Rd, West Dundee, IL 601189301 | 8153386600 | 8474265162 |
| 2507 N Richmond Rd, Mchenry, IL 600515407 | 8153386600 | 8153853255 |
| Street Address |
360 STATION DR |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003815770 | Sandra Jaeschke | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2005-07-15 |
| 1801351648 | Jennifer A Garrels | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2019-02-06 |
| 1285099622 | Juliana Gonzales-hannon | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014 | 2015-12-30 |
| 1487025615 | Tonya Renee Fisher | Registered Nurse | 360 Station Dr, Crystal Lake, IL 60014 | 2015-10-14 |
| 1174917595 | Accelerated Rehabilitation Centers, Ltd | Physical Therapist | 360 Station Dr, Suite 250, Crystal Lake, IL 60014-7978 | 2015-03-24 |
| 1811305329 | Rachel K Ash | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014 | 2014-07-28 |
| 1518383264 | Susan J Bigham | Registered Nurse | 360 Station Dr, Crystal Lake, IL 60014 | 2014-03-05 |
| 1053753582 | Kathleen L Kretchmer | Registered Nurse | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2013-07-25 |
| 1124362306 | Children's Physician Group | Pediatrics | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2012-11-12 |
| 1013261361 | Jenna T Winsko | Nurse Practitioner | 360 Station Dr, Suite 120, Crystal Lake, IL 60014-7978 | 2012-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861785032 | Sharon E. Larsen | Nurse Practitioner | 380 N Terra Cotta Rd Ste E, Crystal Lake, IL 60012-1809 | 2011-05-22 |
| 1467640193 | Kathleen Mccleskey-grimes | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014-8601 | 2007-10-09 |
| 1801351648 | Jennifer A Garrels | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2019-02-06 |
| 1760956726 | Cardinalight Health, LLC | Nurse Practitioner | 380 N Terra Cotta Rd Ste E, Crystal Lake, IL 60012-1809 | 2019-01-13 |
| 1780157602 | Well-rooted Pediatrics LLC | Nurse Practitioner | 820 E Terra Cotta Ave Ste 132, Crystal Lake, IL 60014-3655 | 2019-01-03 |
| 1861987604 | Lisa M Trautman | Nurse Practitioner | 5911 Northwest Hwy Ste 207, Crystal Lake, IL 60014-8043 | 2018-06-25 |
| 1538600820 | Catherine Arend | Nurse Practitioner | 741 S Mchenry Ave, Suite G, Crystal Lake, IL 60014-7445 | 2017-03-20 |
| 1265972418 | Lauren K Mielke | Nurse Practitioner | 781 S Mchenry Ave, Crystal Lake, IL 60014-7444 | 2017-03-06 |
| 1639526015 | Rachelle Puno | Nurse Practitioner | 1305 Randall Rd, Crystal Lake, IL 60014 | 2016-05-16 |
| 1386099208 | Roseann C Iverson | Nurse Practitioner | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1725 | 2016-04-28 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
Please comment or provide details below to improve the information on NANCY RENEE PROKUP.
| 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.