Mary Lynn Puchalski, DNP, APRN, CNS, NNP-

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

209.007309 Issued in IL

Practice address

25 N Winfield Rd
Winfield, IL 60190-1222

Phone

(630) 933-6974

Fax

(630) 933-6335

NPI assigned

Jun 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

Practice roles

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.

• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)
• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1235366402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0S468 MADISON ST",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901479",
            "telephone_number": "630-269-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WINFIELD RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901222",
            "telephone_number": "630-933-6974",
            "fax_number": "630-933-6335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-208-3075",
            "fax_number": "630-308-3474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112991",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCHALSKI",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, CNS, NNP-",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SN0000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Neonatal",
            "state": "IL",
            "license": "209.000948",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "IL",
            "license": "209.007309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Post, PHARMD
• Julie Potzick, M.D.
• Kelly Marie Powell, LCPC
• John Gordon Prout, DO
• Sydney Pucel, AUD
• Manfred James Pyka, MD
• Quality Therapy and Consultation
• Mohiuddin Quayyum
• Amber Amjid Qureshi, D.O.
• Sarika Dinesh Rajguru, MSPT

• Critical Care Neonatal Nurse Practitioner in Winfield, IL
• Providers in Winfield, IL by specialty
• Critical Care Neonatal Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.