Provider Demographics
NPI:1417059759
Name:CONSOLINO-BARSOTTI, GINA THERESA (APN, CNP)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:THERESA
Last Name:CONSOLINO-BARSOTTI
Suffix:
Gender:F
Credentials:APN, CNP
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:THERESA
Other - Last Name:CONSOLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN CNP
Mailing Address - Street 1:190 PROSPECT AVENUE
Mailing Address - Street 2:ELMHURST COLLEGE WELLNESS CENTER
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126
Mailing Address - Country:US
Mailing Address - Phone:630-617-3565
Mailing Address - Fax:630-617-3255
Practice Address - Street 1:190 PROSPECT AVENUE
Practice Address - Street 2:ELMHURST COLLEGE WELLNESS CENTER
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126
Practice Address - Country:US
Practice Address - Phone:630-617-3565
Practice Address - Fax:630-617-3255
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041294923163W00000X
IL209003946363LA2200X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health