Dimitra Panagakis, APN

Individual provider Active NPI Family Nurse Practitioner · Kildeer, IL

NPI 1578099347 · NPPES record last updated May 11, 2017

Key facts

NPI
1578099347
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
209015270 (IL)
Practice address
20836 N Buffalo Run
Kildeer, IL 60047-8532
Phone
(847) 372-0614
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209015270ILMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209015270 IL Yes

Addresses

Primary practice location

20836 N Buffalo Run
Kildeer, IL 60047-8532

Mailing address

20836 N Buffalo Run
Kildeer, IL 60047-8532
Phone (847) 372-0614

Other providers in Kildeer, IL

All providers in Kildeer, IL · Family Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.