Provider Demographics
NPI:1225321771
Name:SCHWARTZ, MAGAN M (MSN, ANP-BC, OCN)
Entity Type:Individual
Prefix:
First Name:MAGAN
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MSN, ANP-BC, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 WEAVER PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3269
Mailing Address - Country:US
Mailing Address - Phone:630-352-5300
Mailing Address - Fax:630-352-5499
Practice Address - Street 1:4405 WEAVER PKWY
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3269
Practice Address - Country:US
Practice Address - Phone:630-352-5300
Practice Address - Fax:630-352-5499
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008048363L00000X
IL209008048364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147082OtherMEDICARE PTAN (INDIVIDUAL)
IL206147OtherMEDICARE PTAN (GROUP)
ILCA4748OtherRAILROAD MEDICARE PTAN (GROUP)
ILP01090264OtherRAILROAD MEDICARE PTAN (INDIVIDUAL)
IL$$$$$$$$$001Medicaid