MARY C BURKE CNM NPI 1497065312

NPI Information

NPI: 1497065312
Provider Name: MARY C BURKE, CNM
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
2850 W 95TH ST
SUITE 103
EVERGREEN PARK, IL
ZIP 60805
Phone: (708) 636-9205
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Mary C Burke, CNM is a primary care nurse practitioner in Evergreen Park, IL with 14 years of experience. Mary C Burke, CNM NPI is 1497065312. 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:

2850 W 95TH ST
SUITE 103
EVERGREEN PARK, IL
ZIP 60805-735
Phone: (708) 636-9205
Fax: (708) 229-6075

The NPI 1497065312 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/13/2010 and was last updated on 12/6/2021.

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	367A00000X	Advanced Practice Midwife		209008340	ILLINOIS	No
2	363LP2300X	Nurse Practitioner	Primary Care	209008339	ILLINOIS	Yes

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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