MS. PHYLLIS RUTH DALLA BETTA (NPI# 1548267479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548267479 |
| Entity Type | Individual |
| Full Name | MS. PHYLLIS RUTH DALLA BETTA |
| Credential | FNP |
| Practice Address |
4805 Prime Pkwy Mchenry IL 60050-7002 |
| Mailing Address |
3103 Almeria Way Longmont CO 80503-7877 |
| Practice Telephone | 8157595448 |
| Mailing Telephone | 3037742068 |
| Mailing Fax Number | 3037742068 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2013-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
47408 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4805 PRIME PKWY |
| City | MCHENRY |
| State | IL |
| Zip Code | 60050-7002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194270926 | Gypsum Medical Associates of California PC | Family Medicine | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2016-08-22 |
| 1396804282 | Jennifer Lee Wetteland | Physician Assistant | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2006-12-06 |
| 1225122344 | Medcor of Barrington, PC | Family Medicine | 4805 Prime Pkwy, Mchenry, IL 60050-7002 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1992274971 | Lisa Luedtke | Counselor | 5342 West Elm Street, Mchenry, IL 60050 | 2018-11-19 |
| 1013402825 | Fox Ridge Medical Associates, LLC | Internal Medicine | 3633 Municipal Dr, Mchenry, IL 60050 | 2018-06-25 |
| 1700387065 | Richard Stacy Birmantas | Speech-Language Pathologist | 6515 West Route 120, Mchenry, IL 60050 | 2018-02-22 |
| 1659888774 | Kathleen Mather | Speech-Language Pathologist | 3502 Washington St, Mchenry, IL 60050 | 2018-01-10 |
| 1891205605 | Delorean Mckinney | Psychologist | 4031 Dayton Ave, Mchenry, IL 60050 | 2017-10-06 |
| 1851810741 | Diana Park | Pharmacist | 2253 N. Richmond Rd., Mchenry, IL 60050 | 2017-09-12 |
| 1063931921 | Lauren M Young | Counselor | 4031 W. Dayton Street, Mchenery, IL 60050 | 2017-09-12 |
| 1376086264 | Elizabeth Kathleen Zacher | Social Worker | 4100 W Dayton Street, Mchenry, IL 60050 | 2016-11-23 |
| 1700332491 | Jasmine Elias | Social Worker | 4031 Dayton St, Mchenry, IL 60050 | 2016-09-01 |
| Find all providers in zip 60050 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225465305 | Christine M Swanson | Nurse Practitioner | 2704 Pueblo Drive, Mchenry, IL 60051 | 2013-10-03 |
| 1063066124 | Lindsay Ann Mattes | Nurse Practitioner | 3901 Mercy Dr, Mchenry, IL 60050-3151 | 2019-07-27 |
| 1083103568 | Katarzyna Maria Brozek | Nurse Practitioner | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2018-05-09 |
| 1912429051 | Erin Rizzo | Nurse Practitioner | 4309 W Medical Center Dr, Mchenry, IL 60050-8419 | 2017-07-11 |
| 1760866784 | Janaies Joseph | Nurse Practitioner | 4201 W Medical Center Dr, Mchenry, IL 60050-8409 | 2015-07-20 |
| 1861814535 | Shenelle Acoy | Nurse Practitioner | 4309 W Medical Center Dr, Ste A102, Mchenry, IL 60050-8419 | 2014-01-14 |
| 1447511944 | Izabela Maria Dalla Valle | Nurse Practitioner | 3901 Mercy Dr, Mchenry, IL 60050-3151 | 2012-05-31 |
| 1033392857 | Josette Dutcher | Nurse Practitioner | 3925 W Elm St, Mchenry, IL 60050-4361 | 2007-12-14 |
| 1124145032 | Laura Beamer | Nurse Practitioner | 4305 W Medical Center Dr, Mchenry, IL 60050-8425 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
| 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 |
| 1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
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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.