ERIN PETRUSIC (NPI# 1124432497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124432497 |
| Entity Type | Individual |
| Full Name | ERIN PETRUSIC |
| Credential | APN, PMHNP |
| Practice Address |
2340 S. Highland Ave, Comprehensive Clinical Services 300 Lombard IL 60148 |
| Mailing Address |
2403 W 32nd Pl Chicago IL 60608-6269 |
| Practice Telephone | 6302611210 |
| Practice Fax Number | 6302611211 |
| Mailing Telephone | 3122174366 |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
309007370 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2340 S. HIGHLAND AVE, COMPREHENSIVE CLINICAL SERVICES 300 |
| City | LOMBARD |
| State | IL |
| Zip Code | 60148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778919 | Alish Kuply | Pharmacist | 2050 S Finley Rd Suite 20, Lombard, IL 60148 | 2020-04-06 |
| 1114567880 | Danielle Slansky | Speech-Language Pathologist | 401 N. Main St, Lombard, IL 60148 | 2020-01-10 |
| 1245715572 | Ellen Mary Corey | Behavior Technician | 627 S Grace St., Lombard, IL 60148 | 2018-10-02 |
| 1194204461 | Vip 2u, Inc | Internal Medicine | 477 E Butterfield Rd Ste 400, Lombard, IL 60148 | 2018-08-08 |
| 1881185684 | Samantha Lanagan | Behavior Technician | 21 W 356 Sidney Ave, Lombard, IL 60148 | 2018-05-29 |
| 1629570114 | Iris Victoria Goss | Hearing Instrument Specialist | 412 E. Roosevelt Rd, Lombard, IL 60148 | 2018-03-01 |
| 1780102350 | Richard Wong | Dentist | 845 S. Main St #300, Lombard, IL 60148 | 2017-09-05 |
| 1033637038 | Lora Lea Biesenkamp | Counselor | 450 E 22nd St Ste 150-17, Lombard, IL 60148 | 2017-08-30 |
| 1609392836 | Shafiq Ur Rehman | Specialist/Technologist, Other | 2005 South Finley Rd Unit 1012, Lombard, IL 60148 | 2017-08-18 |
| 1033642715 | Great Lakes Living Solutions Corp. | Home Health | 477 E. Butterfield Rd., Suite Ll005, Lombard, IL 60148 | 2017-04-09 |
| Find all providers in zip 60148 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407391212 | Davena Janeen Beal | Nurse Practitioner | 2340 S Highland Ave, Suite 300, Lombard, IL 60148-5371 | 2017-01-03 |
| 1265858013 | Marian Glenn | Nurse Practitioner | 2340 S Highland Ave, Suite 300, Lombard, IL 60148-5371 | 2014-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384451 | Ghea Tiping Degillo | Nurse Practitioner | 4711 Golf Rd Ste 500, Skokie, IL 60076-1208 | 2020-10-22 |
| 1750989620 | Rodney J Pena Jr. | Nurse Practitioner | 1362 Trotters Ln, Bourbonnais, IL 60914-4519 | 2020-10-13 |
| 1609482231 | Crystal Lynn Jordan | Nurse Practitioner | 638 Oakbrook Ave, Chatham, IL 62629 | 2020-09-18 |
| 1497369672 | Mojisola Abayemi Akinfe | Nurse Practitioner | 8572 Stone Creek Blvd, Frankfort, IL 60423-9338 | 2020-09-03 |
| 1508475039 | Hilary Eichie | Nurse Practitioner | 20025 Division St., Crest Hill, IL 60403 | 2020-07-30 |
| 1518585942 | Tabs Behavioral Health Inc | Nurse Practitioner | 13316 Vicarage Dr, Plainfield, IL 60585-5050 | 2020-07-13 |
| 1154946788 | Latisha Trenice Stennis | Nurse Practitioner | 8106 Carol Dr, East Saint Louis, IL 62203-1838 | 2020-06-09 |
| 1114549755 | Maria Andreea Bordeianu | Nurse Practitioner | 6050 N California Ave, Chicago, IL 60659-3916 | 2020-05-16 |
| 1104448968 | Abosede Rachel Babalola | Nurse Practitioner | 2214 Monarch St, Bourbonnais, IL 60914-2780 | 2020-05-14 |
| 1659909406 | Mudira Temilola Oyewole | Nurse Practitioner | 493 Leslie Ct, Des Plaines, IL 60016-8818 | 2020-03-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.