Provider Demographics
NPI:1447793203
Name:AUGUSTINE, PHILOMINA KALATHIL (FNP)
Entity Type:Individual
Prefix:
First Name:PHILOMINA
Middle Name:KALATHIL
Last Name:AUGUSTINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 REMINGTON RD
Mailing Address - Street 2:STE H
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4818
Mailing Address - Country:US
Mailing Address - Phone:847-220-2140
Mailing Address - Fax:
Practice Address - Street 1:917 E IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1359
Practice Address - Country:US
Practice Address - Phone:847-368-9646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015190363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily