Provider Demographics
NPI:1437676400
Name:CONNIE CARES FOR KIDS-ADHD AND LEARNING DISABILITIES, LLC
Entity Type:Organization
Organization Name:CONNIE CARES FOR KIDS-ADHD AND LEARNING DISABILITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:APN CPNP
Authorized Official - Phone:630-363-9368
Mailing Address - Street 1:3268 MILLRACE LANE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538
Mailing Address - Country:US
Mailing Address - Phone:630-363-9368
Mailing Address - Fax:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209000942363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty