Doctor Name: | MARY SCHWEIGERT |
NPI Number: | 1134538853 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 209011566 |
Business Practice Address: | 1 University Ave Box 6032 Bourbonnais, IL - 609142345 |
Business Phone Number: | 8159395057 |
Business Fax Number: | 8159354997 |
Mailing Address: | 207 Fox Trail Dr, BOURBONNAIS |
State: | IL |
Postal Code: | 609141734 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/06/2014 |
NPI Last Update Date: | 08/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 209011566 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |