Provider Demographics
NPI:1396389482
Name:CROSS, PATRICE MARIE (APN)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:MARIE
Last Name:CROSS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:PATRICE
Other - Middle Name:MARIE
Other - Last Name:GIUSEFFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1467 BRIARCLIFFE BLVD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-7731
Mailing Address - Country:US
Mailing Address - Phone:630-461-6377
Mailing Address - Fax:
Practice Address - Street 1:908 N ELM ST STE 404
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3638
Practice Address - Country:US
Practice Address - Phone:630-789-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily