Provider Demographics
NPI:1558023598
Name:O'BRIEN, JOAN MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 W 2ND ST STE 4
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4172
Mailing Address - Country:US
Mailing Address - Phone:708-254-8186
Mailing Address - Fax:630-323-4665
Practice Address - Street 1:5 W 2ND ST STE 4
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-4172
Practice Address - Country:US
Practice Address - Phone:708-254-8186
Practice Address - Fax:630-323-4669
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041163065163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health