Manana Burchuladze, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.015401 Issued in IL

Practice address

3295 N Arlington Heights Rd Ste 102
Arlington HTS, IL 60004-1588

Phone

(847) 877-5093

NPI assigned

Feb 15, 2017

Last updated

Feb 15, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1114466752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VILLA VERDE DR",
            "address_2": "# 215",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894173",
            "telephone_number": "847-877-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 N ARLINGTON HEIGHTS RD STE 102",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600041588",
            "telephone_number": "847-877-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCHULADZE",
        "first_name": "MANANA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynda Jean Brown, M.S., L.C.P.C.
• Gail G. Bryant, MD
• Beata Brzezinska
• Dariusz Brzezinski, D.C.
• James Robert Buchholz, LCSW
• Burton S Turek DDS and Allen D Bagdade DDS LTD
• Emily Butryn
• Susan Lynn Catlin, MA LCPC CADC
• Ray Cendejas
• Vicki L Chamberlain, MD

• Family Nurse Practitioner in Arlington HTS, IL
• Providers in Arlington HTS, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.