Provider Demographics
NPI:1629123468
Name:MAULE, PATRICIA LEE (DNP, FNP-BC, AOCNP)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LEE
Last Name:MAULE
Suffix:
Gender:F
Credentials:DNP, FNP-BC, AOCNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LEE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN MS CFNP
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 850
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3124
Mailing Address - Country:US
Mailing Address - Phone:312-695-6180
Mailing Address - Fax:312-695-6189
Practice Address - Street 1:676 N SAINT CLAIR ST STE 850
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3124
Practice Address - Country:US
Practice Address - Phone:312-695-6180
Practice Address - Fax:312-695-6189
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004052363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP89579Medicare UPIN