ELYSE FAGAN (NPI# 1821520800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821520800 |
Entity Type | Individual |
Full Name | ELYSE FAGAN |
Credential | CNS, IBCLC |
Practice Address |
10430 S Spaulding Ave Chicago IL 60655-2427 |
Practice Telephone | 7089459673 |
Mailing Telephone | 7089459673 |
Enumeration Date | 2017-03-29 |
Last Update Date | 2017-03-29 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WL0100X |
Registered Nurse Specialization: Lactation Consultant |
041363532 | IL | Nursing Service Providers |
Street Address |
10430 S SPAULDING AVE |
City | CHICAGO |
State | IL |
Zip Code | 60655-2427 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629632401 | Hillary Woodward Carroll | Nurse Practitioner | 3258 W 111th Chicago, Il, Chicago, IL 60655 | 2019-04-26 |
1679029995 | Meghan Robbins | Pharmacy Technician | 10428 S. Springfield, Chicago, IL 60655 | 2016-08-28 |
1356700728 | Molly Samansky | Speech-Language Pathologist | 2549 W 106thh Pl, Chicago, IL 60655 | 2016-02-15 |
1134533615 | Axis Physical Medicine | Physical Therapist | 11005 S Kedzie Ave, Chicago, IL 60655 | 2014-06-12 |
1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
1962772921 | E.m. Branch and Associates, Inc | Social Worker | 3139 W. 111th Street, Chicago, IL 60655 | 2012-01-09 |
1922377951 | Patricia Murphy | Counselor | 10435 Kedzie Ave, Chicago, IL 60655 | 2011-12-20 |
1346518891 | Kelly Diana Koch | Occupational Therapist | 11143 S. Troy, Chicago, IL 60655 | 2011-12-12 |
1265678544 | Lawrence Michael Furlan | Dentist | 10900 S Kedzie, Chicago, IL 60655 | 2008-12-17 |
1710122361 | Athletico, Ltd | Physical Therapist | 3644 W. 111th Street, Chicago, IL 60655 | 2008-12-11 |
Find all providers in zip 60655 |
Taxonomy Code | 163WL0100X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Lactation Consultant |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043728322 | Nicola Ann Genelly | Registered Nurse | 4545 W Hutchinson St, Chicago, IL 60641-1989 | 2018-01-19 |
1164935102 | Jaudon Rogers | Registered Nurse | 1905 W Foster Ave # 2, Chicago, IL 60640-1025 | 2017-11-13 |
1457765075 | Summer Glynn Kelly | Registered Nurse | 4828 N Neenah Ave, Chicago, IL 60656-4018 | 2014-06-12 |
1447525449 | Elizabeth Susan Sjoblom | Registered Nurse | 2448 W Bloomingdale Ave, Unit 2w, Chicago, IL 60647-6285 | 2012-03-09 |
1235401563 | Gwenan Wilbur | Registered Nurse | 6647 N Talman Ave, Chicago, IL 60645-5008 | 2012-02-01 |
1629218227 | Laura Coulter | Registered Nurse | 4538 N Hermitage Ave, Chicago, IL 60640-5304 | 2009-02-23 |
1538370994 | Martha Petering Johnson | Registered Nurse | 4138 N Harding Ave, Chicago, IL 60618-1943 | 2007-05-25 |
1568680312 | Elizabeth Kelly | Registered Nurse | 4925 N Leavitt St, Chicago, IL 60625-1308 | 2007-04-24 |
1194101220 | Third Coast Lactation LLC | Registered Nurse | 4925 N Leavitt St, Chicago, IL 60625-1308 | 2015-07-30 |
1306252358 | Windy City Baby LLC | Registered Nurse | 4828 N Neenah Ave, Chicago, IL 60656-4018 | 2014-07-10 |
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.