LARETTA WILEY (NPI# 1952885949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952885949 |
Entity Type | Individual |
Full Name | LARETTA WILEY |
Credential | MSN, RN, FNP |
Practice Address |
21224 Gray Hawk Dr Matteson IL 60443-3314 |
Practice Telephone | 7738143885 |
Mailing Telephone | 7738143885 |
Enumeration Date | 2018-09-17 |
Last Update Date | 2018-09-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209018174 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
21224 GRAY HAWK DR |
City | MATTESON |
State | IL |
Zip Code | 60443-3314 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821642497 | Natalie Donyelle Mitchell | Psychologist | 6202 Vollmer Rd Colin Powell Middle School, Elementary Sd 159, Matteson, IL 60443 | 2019-07-31 |
1881199909 | Christopher Anthony Smith | Student in an Organized Health Care Education/Training Program | 5660 Woodgate Dr, Matteson, IL 60443 | 2018-03-29 |
1336695253 | Renato Leano | Physical Therapist | 21020 Kostner Avenue, Matteson, IL 60443 | 2016-08-31 |
1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
1366713125 | Rosanne Miller Tadsen | Counselor | 6201 Vollmer Rd, Matteson, IL 60443 | 2012-01-25 |
1598063281 | Sheri Temple | Occupational Therapist | 3906 212th Place, Matteson, IL 60443 | 2011-03-04 |
1013247576 | Sheila M. Pijus | Counselor | 336 Tullamore Ter., Matteson, IL 60443 | 2010-01-06 |
1962731190 | Benita Yvette Norwoord | Counselor | 600 Holiday Plaza, Matteson, IL 60443 | 2009-12-17 |
1386881654 | Reliance Home Health Services, Inc. | Home Health | 4350 W. Lincoln Hwy #210, Reliance Home Health Services, Inc., Matteson, IL 60443 | 2009-01-08 |
1518139286 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 5640 211th St., Matteson, IL 60443 | 2008-04-02 |
Find all providers in zip 60443 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336782200 | Carmella Jackson | Nurse Practitioner | 916 School Ave, Matteson, IL 60443-1832 | 2019-10-23 |
1134776149 | Ukachi O. Nwankpa | Nurse Practitioner | 1013 Warwick Dr, Matteson, IL 60443-1996 | 2019-08-23 |
1699330910 | Dajauna F Young | Nurse Practitioner | 5125 Monroe St, Matteson, IL 60443-3072 | 2019-05-02 |
1619456548 | Charlette Robinson | Nurse Practitioner | 3760 213th Pl, Matteson, IL 60443-2549 | 2018-08-10 |
1275040651 | Compassionate Health Services LLC | Nurse Practitioner | 5747 Amlin Ter, Matteson, IL 60443-2934 | 2018-01-06 |
1669826657 | Heredeshee Latrice Taylor | Nurse Practitioner | 3201 Holden Cir, Matteson, IL 60443 | 2016-04-16 |
1073944872 | Josephine Nwawueze | Nurse Practitioner | 4428 Clonard Pl, Matteson, IL 60443-2989 | 2013-12-03 |
1659682359 | Therese Marie Melaniphy | Nurse Practitioner | 4647 W. Lincoln Highway, Matteson, IL 60443-2319 | 2010-06-28 |
1821583899 | Ngozi V Ubaghara | Nurse Practitioner | 21209 Sophia Dr, Matteson, IL 60443-1860 | 2018-06-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
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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.