Individual
PATRICIA A PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
25 N WINFIELD RD STE 424, WINFIELD, IL 60190-1379
(630) 933-4056
(630) 933-4057
Mailing address
25 N WINFIELD RD STE 424, WINFIELD, IL 60190-1379
(630) 933-4056
(630) 933-4057
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209005524
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
CDPG BLUE CROSS GROUP
—
01
—
206147
CDPG MEDICARE GRP NUMBER
IL
01
—
363149833
TAX IDENTIFCATION NUMBER
IL
Enumeration date
08/11/2006
Last updated
10/25/2021
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