Marguerite A Wydra

Primary specialty

Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X

License

209-008510 Issued in IL

Practice address

1653 W. Congress Pkwy
622 Murdock
Chicago, IL 60612

Phone

(312) 942-6194

Fax

(312) 942-4370

NPI assigned

Jun 21, 2012

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Interoperability endpoints

• Direct secure messaging: mwydra52385@direct.rush.rush-health.com
• Direct secure messaging: mwydra215736@direct.myadvocateaurora.org

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1255694568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W. CONGRESS PKWY",
            "address_2": "622 MURDOCK",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-942-6194",
            "fax_number": "312-942-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W. CONGRESS PKWY",
            "address_2": "622 MURDOCK",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-942-6194",
            "fax_number": "312-942-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYDRA",
        "first_name": "MARGUERITE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "IL",
            "license": "209-008510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Wychocki, LCSW
• Mairghread R Wycklendt, RD, LDN
• Kelly Wyckoff, MS, RD, LDN, CNSD
• Sarah L Wyckoff
• Michal M Wyczesany, DPT
• Mary R. Wyers, MD
• Cassandra Wygant, DPM
• Jeffrey Benjamin Wygodny, M,D,
• Rosanne Wygodny, HEALTH COACH
• Tobi Wyld, LCSW

• Pediatric Clinical Nurse Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.