Active NPI
Laura Hunnell, PA-C
- Physician Assistant
- Park Ridge, IL
National Provider Identifier
1174069363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085006026
- Practice address
- 1875 Dempster St
Suite 410
Park Ridge, IL 60068-1186 - Phone
- (847) 723-9052
- Fax
- (847) 723-9441
- NPI assigned
- Jan 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085006026 | IL | Primary |
Addresses
Primary practice location
1875 Dempster St
Suite 410
Park Ridge, IL 60068-1186
Mailing address
1875 Dempster St
Suite 410
Park Ridge, IL 60068-1186
Phone (847) 723-9052
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085006026 | IL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1174069363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1875 DEMPSTER ST",
"address_2": "SUITE 410",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681186",
"telephone_number": "847-723-9052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1875 DEMPSTER ST",
"address_2": "SUITE 410",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600681186",
"telephone_number": "847-723-9052",
"fax_number": "847-723-9441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNNELL",
"first_name": "LAURA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-11",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085006026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.