Provider Demographics
NPI:1578817003
Name:FUNES, IRMA E (ANP)
Entity Type:Individual
Prefix:MRS
First Name:IRMA
Middle Name:E
Last Name:FUNES
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 1:5341 CAROL ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2002
Mailing Address - Country:US
Mailing Address - Phone:847-965-1901
Mailing Address - Fax:847-965-1952
Practice Address - Street 1:8950 GROSS POINT RD
Practice Address - Street 2:STE. 300
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1886
Practice Address - Country:US
Practice Address - Phone:847-965-1901
Practice Address - Fax:847-965-1952
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-009925363LA2200X
IL209009925363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health