Provider Demographics
NPI:1427567080
Name:PLAKKAL, BEENA (NP-C)
Entity Type:Individual
Prefix:
First Name:BEENA
Middle Name:
Last Name:PLAKKAL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 BRIARHILL DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-3147
Mailing Address - Country:US
Mailing Address - Phone:1630-717-7279
Mailing Address - Fax:
Practice Address - Street 1:2256 BRIARHILL DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-3147
Practice Address - Country:US
Practice Address - Phone:1630-717-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily