JOANN F PETTY (NPI# 1780889626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780889626 |
| Entity Type | Individual |
| Full Name | JOANN F PETTY |
| Credential | APN CNS |
| Practice Address |
4405 Weaver Pkwy Warrenville IL 60555-3269 |
| Practice Telephone | 6303525300 |
| Practice Fax Number | 6303525499 |
| Mailing Telephone | 6303525300 |
| Mailing Fax Number | 6303525499 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2013-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SX0200X |
Clinical Nurse Specialist Specialization: Oncology |
209004957 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE RAILROAD PTAN (GROUP) | CA4748 | 01 |
| IL | MEDICARE PTAN (INDIVIDUAL) | 206147075 | 01 |
| IL | MEDICARE PTAN (GROUP) | 206147 | 01 |
| IL | MEDICARE RAILROAD PTAN (INDIVIDUAL) | P01013439 | 01 |
| Street Address |
4405 WEAVER PKWY |
| City | WARRENVILLE |
| State | IL |
| Zip Code | 60555-3269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477540821 | John D Ayers | Internal Medicine | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2005-09-30 |
| 1578032546 | Sarah Knobbe | Nurse Practitioner | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2018-11-19 |
| 1982189221 | Madeline Mccue Bice | Nurse Practitioner | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2018-10-02 |
| 1932691177 | Elizabeth Beverly Strus | Registered Nurse | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2018-06-04 |
| 1114461019 | Lauren Marie Weston | Physician Assistant | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2016-12-12 |
| 1497205504 | Kelly Schaefer | Nurse Practitioner | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2016-10-12 |
| 1356897912 | Valerie Perona | Registered Nurse | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2016-09-01 |
| 1124494711 | Osaama Khan | Neurological Surgery | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2015-08-18 |
| 1821485335 | Jaime Rohde | Nurse Practitioner | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2015-04-22 |
| 1093111957 | Carrie A Feid | Nurse Practitioner | 4405 Weaver Pkwy, Warrenville, IL 60555-3269 | 2014-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053944546 | Deloris Abrahams Morgan | Physical Therapist | Symbria Rehab, 28100 Torch Parkway Suite 600, Warrenville, IL 60555 | 2020-02-13 |
| 1306479894 | Lauri Ann Mccrorey | Physical Therapist | Symbria Rehab 28100 Torch Parkway, Suite 600, 600, Warrenville, IL 60555 | 2020-02-13 |
| 1699241455 | Jason Villanueva | Occupational Therapist | 2 S 521 River Oaks Dr, Warrenville, IL 60555 | 2018-10-19 |
| 1558885715 | Carol Renee Powers | Nurse Practitioner | 28375 Davis Parkway, Suite 903, Warrenville, IL 60555 | 2017-07-31 |
| 1245613249 | Bryce Alan Larson | Dentist | 28377 Davis Pkwy Ste 609, Warrenville, IL 60555 | 2015-07-08 |
| 1982092078 | Metropolitan Family Services | Community/Behavioral Health | 27475 Ferry Road Suite 120, Americenter of Naperville Warrenville, Warrenville, IL 60555 | 2014-12-26 |
| 1306248505 | A & A Clinical Counseling Solutions, Inc. | Psychologist | 4580 Weaver Parkway Suite 204, Warrenville, IL 60555 | 2014-09-18 |
| 1538412242 | Kirsten Holly Rasmussen | Counselor | 29w120 Butterfield Road, Suite 104 A, Warrenville, IL 60555 | 2012-10-18 |
| 1871881110 | Marianne Huml | Registered Nurse | 4405 Weaver Parkway, Suite 201, Central Dupage Hospital Cancer Center, Warrenville, IL 60555 | 2011-07-20 |
| 1649405341 | James Wade | Surgery | 4405 Weaver Parkway, Warrenville, IL 60555 | 2009-05-26 |
| Find all providers in zip 60555 | ||||
| Taxonomy Code | 364SX0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Oncology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073714663 | Carole Sims Henn Martz | Clinical Nurse Specialist | 757 Park West, Highland Park Hospital, Highland Park, IL 60035 | 2007-05-30 |
| 1972684066 | Valerie Wodzinski | Clinical Nurse Specialist | 119 Northgate, Riverside, IL 60541 | 2006-10-17 |
| 1124629035 | Carla Sue Smith | Clinical Nurse Specialist | 1005 Broadway St, Quincy, IL 62301-2834 | 2020-11-06 |
| 1346870177 | Margaret M Gregus | Clinical Nurse Specialist | 121 N Elm St, Hinsdale, IL 60521-3765 | 2020-01-21 |
| 1245742949 | Jill C Benedeck | Clinical Nurse Specialist | 4305 W Medical Center Dr, Mchenry, IL 60050-8425 | 2017-11-02 |
| 1497096853 | Mary Eileen Callaghan | Clinical Nurse Specialist | 250 E Superior St, Prentice 14-2226, Chicago, IL 60611-2914 | 2013-03-11 |
| 1902166754 | Kimberly Lisa Valachovic | Clinical Nurse Specialist | 676 N Saint Clair St, Suite 850, Chicago, IL 60611-2927 | 2012-05-25 |
| 1215224274 | Jacqueline Ann Rohaly-davis | Clinical Nurse Specialist | 15750 Marian Dr, Homer Glen, IL 60491-6200 | 2011-06-28 |
| 1366768764 | Mary Colleen Welles | Clinical Nurse Specialist | 676 N Saint Clair St, Suite 2125, Chicago, IL 60611-2927 | 2010-04-12 |
| 1043449416 | Deborah A. Stlaske | Clinical Nurse Specialist | 4440 W 95th St, Oak Lawn, IL 60453-2600 | 2009-07-07 |
| Find all providers with the same taxonomy | ||||
| City | WARRENVILLE |
| Zip Code | 60555 |
Please comment or provide details below to improve the information on JOANN F PETTY.
| 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.