Provider Demographics
NPI:1528200540
Name:NERI-HARDT, MADALINE (ANP)
Entity Type:Individual
Prefix:
First Name:MADALINE
Middle Name:
Last Name:NERI-HARDT
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E NORTH WATER ST
Mailing Address - Street 2:UNIT 702
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 E NORTH WATER ST
Practice Address - Street 2:UNIT 702
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5594
Practice Address - Country:US
Practice Address - Phone:773-771-2451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.001515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily