Provider Demographics
NPI:1437274651
Name:PARR, CONNIE L (APN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:L
Last Name:PARR
Suffix:
Gender:F
Credentials:APN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4580 WEAVER PARKWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3864
Mailing Address - Country:US
Mailing Address - Phone:630-473-3970
Mailing Address - Fax:630-994-5028
Practice Address - Street 1:4580 WEAVER PKWY STE 204
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3864
Practice Address - Country:US
Practice Address - Phone:630-473-3970
Practice Address - Fax:630-994-5028
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000942363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics