Prokup, Nancy Renee
Prokup, Nancy Renee is an individual health care provider with primary practice located at 360 Station Dr , Crystal Lake IL 60014. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Prokup, Nancy Renee 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 209008330 | Illinois |
Profile Details
| NPI number | 1306155072 |
|---|---|
| LBN Legal business name | Prokup, Nancy Renee |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2010 |
| Last updated | Mar 18th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306155072 | NPPES |
| Illinois | Other | 209008330 | STATE LICENSE |
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