Individual
MISS ABBIGAYLE MAE DOERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, FNP-BC, RN
Contact information
Practice address
680 N LAKE SHORE DR, SUITE# 100, CHICAGO, IL 60611-4546
(312) 695-0665
(312) 695-0050
Mailing address
680 N LAKE SHORE DR, SUITE# 100, CHICAGO, IL 60611-4546
(312) 695-0665
(312) 695-0050
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.009042
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041341141
MEDICAID
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400112304
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
08/31/2011
Last updated
09/03/2015
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