Provider Demographics
NPI:1639743909
Name:SWANSON, KAREN L (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:SWANSON
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 HALIGUS RD STE 200D
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-9545
Mailing Address - Country:US
Mailing Address - Phone:847-802-7280
Mailing Address - Fax:847-802-7275
Practice Address - Street 1:10350 HALIGUS RD STE 200D
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-9545
Practice Address - Country:US
Practice Address - Phone:847-802-7280
Practice Address - Fax:847-802-7275
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018724363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner