Provider Demographics
NPI:1235287889
Name:PLOSKI, AMANDA MARIE (APN)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:PLOSKI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:STODD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:995 COMMONWEALTH CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3154
Mailing Address - Country:US
Mailing Address - Phone:773-610-4808
Mailing Address - Fax:
Practice Address - Street 1:370 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-3843
Practice Address - Country:US
Practice Address - Phone:847-608-1344
Practice Address - Fax:847-841-6739
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006377363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily