Provider Demographics
NPI:1790240281
Name:SIMMONS, MARGARET (APRN)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:461 BERKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1017
Mailing Address - Country:US
Mailing Address - Phone:773-628-3317
Mailing Address - Fax:
Practice Address - Street 1:5215 N CALIFORNIA AVE STE 603
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-8564
Practice Address - Country:US
Practice Address - Phone:773-878-3627
Practice Address - Fax:773-293-8824
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041352309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily