Individual
JULIE K MIYAMASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
200 E ROOSEVELT RD, VILLA PARK, IL 60181-3500
(800) 323-8622
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
103439-875
WI
363L00000X
Nurse Practitioner
Primary
209-005257
IL
363L00000X
Nurse Practitioner
277-000556
IL
363LF0000X
Family Nurse Practitioner
277-000556
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100396295
—
WI
Enumeration date
06/04/2006
Last updated
01/29/2026
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