DESIREE MICHELLE PROVAX (NPI# 1942760962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942760962 |
| Entity Type | Individual |
| Full Name | DESIREE MICHELLE PROVAX |
| Credential | APN |
| Practice Address |
5237 W Windsor Ave Chicago IL 60630-3720 |
| Practice Telephone | 7735473544 |
| Mailing Telephone | 7735473544 |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.018899 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5237 W WINDSOR AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60630-3720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972116499 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 4631 W Foster Ave, Chicago, IL 60630 | 2020-08-25 |
| 1811419476 | Jill Swartzmiller | Occupational Therapist | 5248 N Liano Ave, Chicago, IL 60630 | 2017-07-14 |
| 1588193908 | Vanessa Landa | Behavior Technician | 4831 N Mobile, Chicago, IL 60630 | 2017-06-08 |
| 1851753784 | Claudia Melendez | Counselor | 4935 N Kedvale Ave., 1st Flr., Chicago, IL 60630 | 2016-03-21 |
| 1174983795 | Cheryl Ann Howe | Speech-Language Pathologist | 4714 N. Laramie Ave., Chicago, IL 60630 | 2016-02-24 |
| 1740657055 | Nihar Shah | Pharmacist | 4010 W Lawrence, Chicago, IL 60630 | 2015-08-24 |
| 1326450966 | Robert E Placzek | Dentist | 5650 W. Lawrence Ave., Chicago, IL 60630 | 2014-06-02 |
| 1730426545 | Violet Bernadet Mcguane | Nurse Practitioner | 4801 N Central, Chicago, IL 60630 | 2013-01-14 |
| 1639455231 | Jinnah A Caluag | Pharmacist | 4010 W. Lawrence, Chicago, IL 60630 | 2011-10-26 |
| 1255616256 | Marcus Kim | Pharmacist | 4010 W. Lawrence Ave, Chicago, IL 60630 | 2011-10-21 |
| Find all providers in zip 60630 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
| 1881291706 | Rita Elue | Nurse Practitioner | 6241 N Winthrop Ave Apt 307, Chicago, IL 60660-2071 | 2020-10-04 |
| 1558976514 | Janice Nicole Kinney | Nurse Practitioner | 10127 S Harding Ave, Chicago, IL 60655-3748 | 2020-09-15 |
| 1881209278 | Monique Graves | Nurse Practitioner | 4912 W Adams St Apt 2, Chicago, IL 60644-4445 | 2020-09-11 |
| 1194339721 | Maureen Iyesogie Diji | Nurse Practitioner | 4658 S Ellis Ave, Chicago, IL 60653-3625 | 2020-09-01 |
| 1669085395 | Emily Calderon | Nurse Practitioner | 5556 N Sheridan Rd Apt 506, Chicago, IL 60640-1677 | 2020-08-24 |
| 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.