Provider Demographics
NPI:1003096918
Name:LOSURDO, JUNE R (APN-CNP)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:R
Last Name:LOSURDO
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 N ELM ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3635
Mailing Address - Country:US
Mailing Address - Phone:630-789-3422
Mailing Address - Fax:630-789-9093
Practice Address - Street 1:908 N ELM ST
Practice Address - Street 2:SUITE 404
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3635
Practice Address - Country:US
Practice Address - Phone:630-789-3422
Practice Address - Fax:630-789-9093
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-251934163W00000X
IL209-014168363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1912218850OtherGROUP PRACTICE NPI
ILF400296542OtherMEDICARE PTAN LOC15
ILF400296540OtherMEDICARE PTAN LOC16