PRESENCE PROVISO FAMILY SERVICES INC NPI 1235411703

NPI Information

  • NPI: 1235411703
  • Provider Name: PRESENCE PROVISO FAMILY SERVICES INC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: PROVISO FAMILY SERVICES INC
  • Address: 2940 N ASHLAND AVE
    CHICAGO, IL
    ZIP 60657
  • Phone: (773) 525-4440

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NPI Details

PRESENCE PROVISO FAMILY SERVICES INC is a family nurse practitioner in Chicago, IL. PRESENCE PROVISO FAMILY SERVICES INC NPI is 1235411703. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Proviso Family Services Inc.

The provider's business location address is:

2940 N ASHLAND AVE
CHICAGO, IL
ZIP 60657-004
Phone: (773) 525-4440
Fax: (773) 525-7771

The provider's authorized official is Melvonne Wickliffe-jones .
The authorized official title is Credentialing Mgr and has the following contact phone number (630) 914-2417.

The enumeration date for this NPI number is 9/12/2011 and was last updated on 4/9/2013.

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
1363LF0000XNurse PractitionerFamilyILLINOISYes

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: 3/30/2025

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