Provider Demographics
NPI:1033659552
Name:SKUBLE, HEATHER (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:SKUBLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:F
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:5311 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-1006
Mailing Address - Country:US
Mailing Address - Phone:773-586-0076
Mailing Address - Fax:
Practice Address - Street 1:5311 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-1006
Practice Address - Country:US
Practice Address - Phone:773-586-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011497363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily