AJIE JIBU MAMMARAPPALLIL AGACNP NPI 1215510987

NPI Information

NPI: 1215510987
Provider Name: AJIE JIBU MAMMARAPPALLIL, AGACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Address:
12251 S 80TH AVE
PALOS HEIGHTS, IL
ZIP 60463
Phone: (708) 923-4000
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Ajie Jibu Mammarappallil, AGACNP is an acute care nurse practitioner in Palos Heights, IL. Ajie Jibu Mammarappallil, AGACNP NPI is 1215510987. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12251 S 80TH AVE
PALOS HEIGHTS, IL
ZIP 60463-290
Phone: (708) 923-4000

The enumeration date for this NPI number is 4/30/2021 and was last updated on 4/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	209022913	ILLINOIS	Yes
2	363LG0600X	Nurse Practitioner	Gerontology	209022913	ILLINOIS	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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