Provider Demographics
NPI:1518183839
Name:ARNOLD, MARILYN JEAN (RN, MSN, ANP-CS)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:JEAN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RN, MSN, ANP-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1919 S HIGHLAND AVE
Mailing Address - Street 2:SUITE B202 - ATTN: JAN LEWIS
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6153
Mailing Address - Country:US
Mailing Address - Phone:630-785-4364
Mailing Address - Fax:
Practice Address - Street 1:429 N YORK RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2003
Practice Address - Country:US
Practice Address - Phone:630-782-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-001184363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL602930004Medicare PIN