Provider Demographics
NPI:1245774132
Name:MYERS-WOODS, ADRIENN (NP-C)
Entity Type:Individual
Prefix:
First Name:ADRIENN
Middle Name:
Last Name:MYERS-WOODS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 N SHERIDAN RD
Mailing Address - Street 2:SUITE 902
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-7227
Mailing Address - Country:US
Mailing Address - Phone:773-904-8641
Mailing Address - Fax:
Practice Address - Street 1:840 W IRVING PARK RD STE 305
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3011
Practice Address - Country:US
Practice Address - Phone:773-975-6775
Practice Address - Fax:773-975-3289
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.015185363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400355682Medicare PIN