Holem, Mary Ann

Holem, Mary Ann is an individual health care provider with primary practice located at 360 Station Dr , Crystal Lake IL 60014. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Holem, Mary Ann can be contacted via phone (815) 338-6600.

Contact Information

Primary practice address
360 Station Dr Crystal Lake IL 60014
Phone: (815) 338-6600
Fax: (815) 455-8044
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209008856 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209008856 Illinois

Profile Details

NPI number 1972897791
LBN Legal business name Holem, Mary Ann
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2011
Last updated Oct 19th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972897791 NPPES
Illinois Other 209008856 STATE LICENSE

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