JEANNE A WIESBROCK (NPI# 1366705071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366705071 |
| Entity Type | Individual |
| Full Name | JEANNE A WIESBROCK |
| Credential | APN, CNS |
| Practice Address |
1775 Dempster St Park Ridge IL 60068-1143 |
| Mailing Address |
1707 Pine St Spring Grove IL 60081-8099 |
| Practice Telephone | 8477237046 |
| Mailing Telephone | 8156759106 |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SN0000X |
Clinical Nurse Specialist Specialization: Neonatal |
209.009545 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1775 DEMPSTER ST |
| City | PARK RIDGE |
| State | IL |
| Zip Code | 60068-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386642452 | Asya S. Ali | Pathology | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2005-07-12 |
| 1245847656 | Susie Annette Gonzalez | Nurse Practitioner | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-29 |
| 1598370231 | Maria Staed Dwyer | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1851906598 | Izabela Koszczuk | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1760097406 | Mark Andrew Fasick | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-09-10 |
| 1962014183 | Eric Swanson | Nurse Anesthetist, Certified Registered | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-08-19 |
| 1740804046 | Lauren Kay | Nurse Practitioner | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-06-02 |
| 1326660234 | Kellyn Bailey | Occupational Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-05-13 |
| 1659992964 | Emma Hogaboom | Physical Therapist | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-04-28 |
| 1003436403 | Sandra Kroschel | Nurse's Aide | 1775 Dempster St, Park Ridge, IL 60068-1143 | 2020-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861010720 | Caitlin Marie Kompanowski | Dentist | 412 W. Talcott, Park Ridge, IL 60068 | 2020-07-08 |
| 1972142198 | Center for Authentic Living, Inc. | Counselor | 120 Main Street Suite 200, Park Ridge, IL 60068 | 2020-01-06 |
| 1306312152 | Maryann Almores Devilla | Physical Medicine & Rehabilitation | Sunrise Assisted Living, 1725 Ballard Road, Park Ridge, IL 60068 | 2018-10-19 |
| 1053808857 | Landon Ginsberg | Student in an Organized Health Care Education/Training Program | 1775 Ballard, Park Ridge, IL 60068 | 2018-04-17 |
| 1255828448 | Vera W Brink | Obstetrics & Gynecology | Parkside Professional Center, 1875 Dempster St., Ste. 330, Park Ridge, IL 60068 | 2018-04-13 |
| 1205367448 | Courtney Heim | Psychiatry & Neurology | 1875 W.dempster Street - Park Side Professional Center, Ste 470, Park Ridge, IL 60068 | 2017-03-21 |
| 1720521362 | Alexander Mylonas | Psychologist | 1400 Renaissance Dr Ste 401, Park Ridge, IL 60068 | 2016-11-30 |
| 1376090878 | Rebecca Rajasekhar | Audiologist | 1030 W. Higgins Rd., Audiology Room 6, Park Ridge, IL 60068 | 2016-09-01 |
| 1164818449 | Mohammad Taha Mustaf Taha Mustafa Sheikh | Student in an Organized Health Care Education/Training Program | 1550 North Northwest Highway Suite 107, L.m. Prasad, Md, Sc, Park Ridge, IL 60068 | 2015-04-13 |
| 1518397918 | Megan Roberts | Speech-Language Pathologist | 2240 Campus Dr., Evanston, IL 60068 | 2013-11-21 |
| Find all providers in zip 60068 | ||||
| Taxonomy Code | 364SN0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Neonatal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780901843 | Bernadette M Taylor | Clinical Nurse Specialist | 5721 S Maryland Ave # K280, Chicago, IL 60637-1425 | 2010-04-29 |
| 1891231312 | Jill Alden | Clinical Nurse Specialist | 660 N Westmoreland Rd, Lake Forest, IL 60045-1659 | 2017-01-07 |
| 1174066153 | Amanda Erman | Clinical Nurse Specialist | 5841 S Maryland Ave, Chicago, IL 60637-1447 | 2016-11-23 |
| 1265889596 | Tonya Mangiaguerra | Clinical Nurse Specialist | 801 S Washington St, Naperville, IL 60540-7430 | 2016-05-17 |
| 1467789511 | Julie Tuttle | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61530 | 2009-11-11 |
| City | PARK RIDGE |
| Zip Code | 60068 |
Please comment or provide details below to improve the information on JEANNE A WIESBROCK.
| 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.