Provider Demographics
NPI:1003348103
Name:ENGER, IVY MILLAR (APN-CNP)
Entity Type:Individual
Prefix:
First Name:IVY
Middle Name:MILLAR
Last Name:ENGER
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 1:100 SPALDING DR STE 206
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6552
Mailing Address - Country:US
Mailing Address - Phone:630-646-7250
Mailing Address - Fax:630-548-7743
Practice Address - Street 1:100 SPALDING DR STE 206
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6552
Practice Address - Country:US
Practice Address - Phone:630-646-7250
Practice Address - Fax:630-548-7743
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily