Provider Demographics
NPI:1275668212
Name:ATKINSON, GLORIA (CANP)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:CANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 E ALGONQUIN RD
Mailing Address - Street 2:STE. 504
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4187
Mailing Address - Country:US
Mailing Address - Phone:847-397-1215
Mailing Address - Fax:847-397-1216
Practice Address - Street 1:2040 E ALGONQUIN RD
Practice Address - Street 2:STE. 504
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4187
Practice Address - Country:US
Practice Address - Phone:847-397-1215
Practice Address - Fax:847-397-1216
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0193960363LA2200X, 363LA2200X
IL209005462363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.005462OtherADVANCED PRACTICE NURSE
ILK26480Medicare UPIN