Provider Demographics
NPI:1952682742
Name:MONHARDT, MARIE E (APN)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:E
Last Name:MONHARDT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SO WASHINGTON STR
Mailing Address - Street 2:EDWARD HOSPITAL
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60450
Mailing Address - Country:US
Mailing Address - Phone:630-527-5102
Mailing Address - Fax:630-416-8694
Practice Address - Street 1:801 SO WASHINGTON STR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60450
Practice Address - Country:US
Practice Address - Phone:630-527-5102
Practice Address - Fax:630-416-8694
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003151363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner