Angela Campbell

Individual provider Active NPI Nurse Practitioner · Winfield, IL

NPI 1013342906 · NPPES record last updated May 5, 2023

Key facts

NPI
1013342906
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
209010885 (IL)
Practice address
25 N Winfield Rd
Winfield, IL 60190-1379
Phone
(630) 933-1172
NPI assigned
Sep 10, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
041362244ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Taras W. Didenko, MD, PC Past
since Feb 1, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041362244 IL
Nurse Practitioner 363L00000X 209010885 IL Yes

Addresses

Primary practice location

25 N Winfield Rd
Winfield, IL 60190-1379

Mailing address

25 N Winfield Rd
Winfield, IL 60190-1379
Phone (630) 933-1172

Other providers in Winfield, IL

All providers in Winfield, IL · Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.