Provider Demographics
NPI:1962827881
Name:BURDA, JANET E (APRN, CNS)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:E
Last Name:BURDA
Suffix:
Gender:F
Credentials:APRN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 WEST AVE STE 223
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4509
Mailing Address - Country:US
Mailing Address - Phone:708-923-7874
Mailing Address - Fax:708-923-7876
Practice Address - Street 1:15300 WEST AVE STE 223
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4509
Practice Address - Country:US
Practice Address - Phone:708-923-7874
Practice Address - Fax:708-923-7876
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL277.000593364SA2200X
IL277000593363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400295744OtherMEDICARE PTAN
ILF400295744OtherMEDICARE PTAN