Provider Demographics
NPI:1326682378
Name:DRAKE, CARI ANN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:ANN
Last Name:DRAKE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CARI
Other - Middle Name:ANN
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2210 N 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3037
Mailing Address - Country:US
Mailing Address - Phone:243-888-5692
Mailing Address - Fax:
Practice Address - Street 1:261 N YORK ST STE 102
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2757
Practice Address - Country:US
Practice Address - Phone:708-685-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-03
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018276363LF0000X
IL277002705363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily