Provider Demographics
NPI:1013494236
Name:HEJAZINIA, THERESE ANN (APN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:ANN
Last Name:HEJAZINIA
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 OLD FARM CT
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60046-4970
Mailing Address - Country:US
Mailing Address - Phone:773-569-0137
Mailing Address - Fax:
Practice Address - Street 1:WESTMORELAND OBGYN ASSOCIATE
Practice Address - Street 2:917 SHERWOOD DR. SUITE 200
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044
Practice Address - Country:US
Practice Address - Phone:847-234-9110
Practice Address - Fax:847-739-0970
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI228172363LF0000X
WI877533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily