Provider Demographics
NPI:1649220534
Name:CROWLEY, MAUREEN (CNP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 S MARYLAND AVE RM E102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1443
Mailing Address - Country:US
Mailing Address - Phone:773-702-1865
Mailing Address - Fax:773-834-3888
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:UNIVERSITY OF CHICAGO MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-702-4851
Practice Address - Fax:773-834-3888
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-000503363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health