Provider Demographics
NPI:1790301331
Name:EGUIA, CLAUDYN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CLAUDYN
Middle Name:
Last Name:EGUIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9012 KEATING AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1593
Mailing Address - Country:US
Mailing Address - Phone:773-456-6815
Mailing Address - Fax:
Practice Address - Street 1:666 DUNDEE RD STE 802
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2734
Practice Address - Country:US
Practice Address - Phone:847-498-1515
Practice Address - Fax:847-498-2362
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty