Sandra Abraham, CNP
Individual provider Active NPI Nurse Practitioner · Dwight, IL
NPI 1982883245 · NPPES record last updated Oct 6, 2014
Key facts
- NPI
- 1982883245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209006840 (IL)
- Practice address
- 313 Andrew Ave
Dwight, IL 60420-1645 - Phone
- (630) 605-5234
- NPI assigned
- Nov 2, 2007
- 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
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209006840 | IL | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209006840 | IL | Yes |
Addresses
Primary practice location
313 Andrew Ave
Dwight, IL 60420-1645
Mailing address
PO Box 274
Dwight, IL 60420-0274
Phone (630) 605-5234
Other providers in Dwight, IL
- Brenda Jean Abate
- Arc at Dwight LLC
- Arc at Dwight LLC
- Jeffery Ray Bennett
- Joan M. Bistry
- Modinat Iretioluwa Bokin
All providers in Dwight, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.