Provider Demographics
NPI:1518219757
Name:DOWNS, AMANDA K (APN-CNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:K
Last Name:DOWNS
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 RIDGE AVE.
Mailing Address - Street 2:WALGREEN 3507
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-2868
Mailing Address - Fax:847-733-5005
Practice Address - Street 1:2650 RIDGE AVE.
Practice Address - Street 2:WALGREEN 3507
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201
Practice Address - Country:US
Practice Address - Phone:847-570-2868
Practice Address - Fax:847-733-5005
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041364293163W00000X
IL209009883363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse