Provider Demographics
NPI:1164723110
Name:MALUNHAO, ANA MARIE (APN-CNP)
Entity Type:Individual
Prefix:
First Name:ANA MARIE
Middle Name:
Last Name:MALUNHAO
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 1:777 PARK AVE. WEST
Mailing Address - Street 2:IM HOSPITALISTS
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035
Mailing Address - Country:US
Mailing Address - Phone:847-926-5840
Mailing Address - Fax:847-926-5835
Practice Address - Street 1:777 PARK AVE. WEST
Practice Address - Street 2:IM HOSPITALISTS
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035
Practice Address - Country:US
Practice Address - Phone:847-926-5840
Practice Address - Fax:847-926-5835
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008402363L00000X
IL209.008402363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner