Provider Demographics
NPI:1861845240
Name:MUNROE, MICHELLE J (APN-CNP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:MUNROE
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 2140
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3143
Mailing Address - Country:US
Mailing Address - Phone:312-695-0990
Mailing Address - Fax:312-695-0468
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2140
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3143
Practice Address - Country:US
Practice Address - Phone:312-695-0990
Practice Address - Fax:312-695-0468
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014429363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health