Provider Demographics
NPI:1578072815
Name:FORD-KENDRICK, ONNA (APN FNP-C)
Entity Type:Individual
Prefix:
First Name:ONNA
Middle Name:
Last Name:FORD-KENDRICK
Suffix:
Gender:F
Credentials:APN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9119 S EXCHANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-4225
Mailing Address - Country:US
Mailing Address - Phone:773-768-5000
Mailing Address - Fax:
Practice Address - Street 1:151 E. BRIARCLIFF RD
Practice Address - Street 2:-
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440
Practice Address - Country:US
Practice Address - Phone:630-783-2832
Practice Address - Fax:630-783-2832
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily