Provider Demographics
NPI:1861634982
Name:CLIFFORD-FURLAN, JULIA ANNE (NP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANNE
Last Name:CLIFFORD-FURLAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:JULI
Other - Middle Name:ANNE
Other - Last Name:FURLAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, CNRN
Mailing Address - Street 1:1725 W HARRISON ST
Mailing Address - Street 2:SUITE 855
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3841
Mailing Address - Country:US
Mailing Address - Phone:312-942-6644
Mailing Address - Fax:312-942-2176
Practice Address - Street 1:1725 W HARRISON ST
Practice Address - Street 2:SUITE 855
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3841
Practice Address - Country:US
Practice Address - Phone:312-942-6644
Practice Address - Fax:312-942-2176
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0041-305278163W00000X
IL209-008245363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse