Provider Demographics
NPI:1619184991
Name:GARVEY, PEGGY ANN (NP)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:ANN
Last Name:GARVEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E CHICAGO AVE, BOX 43
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2605
Mailing Address - Country:US
Mailing Address - Phone:312-227-6260
Mailing Address - Fax:312-227-9419
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1222
Practice Address - Country:US
Practice Address - Phone:312-227-6260
Practice Address - Fax:312-227-9419
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-002851363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics