Provider Demographics
NPI:1598851610
Name:PROKUSKI, NOREEN E (CNM)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:E
Last Name:PROKUSKI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 OGDEN AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-5894
Mailing Address - Country:US
Mailing Address - Phone:630-978-4800
Mailing Address - Fax:
Practice Address - Street 1:2020 OGDEN AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5894
Practice Address - Country:US
Practice Address - Phone:630-978-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife