Mendoza, Mae Grace

Mendoza, Mae Grace is an individual health care provider with primary practice located at 3880 Salem Lake Dr # F , Long Grove IL 60047-5292. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Mendoza, Mae Grace can be contacted via phone (847) 235-3072.

Contact Information

Primary practice address
3880 Salem Lake Dr # F Long Grove IL 60047-5292
Phone: (847) 235-3072
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041356399 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209014869 Illinois

Profile Details

NPI number 1023563335
LBN Legal business name Mendoza, Mae Grace
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2016
Last updated Mar 7th, 2023 - about last year

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 1023563335 NPPES
Illinois MEDICAID 209014869

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