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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306155072 NPPES
Illinois Other 209008330 STATE LICENSE

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