Provider Demographics
NPI:1417328675
Name:COX, NANCY (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 DIXIE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-1974
Mailing Address - Country:US
Mailing Address - Phone:708-799-8384
Mailing Address - Fax:708-799-1305
Practice Address - Street 1:1835 DIXIE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-1974
Practice Address - Country:US
Practice Address - Phone:708-799-8384
Practice Address - Fax:708-799-1305
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28077700A363L00000X
IL209013369363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner