Provider Demographics
NPI:1265916415
Name:DOBREZ, EMILY ANN (FNP-BC, BSN, RN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:DOBREZ
Suffix:
Gender:F
Credentials:FNP-BC, BSN, RN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:DOBREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:4631 CLAUSEN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1641
Mailing Address - Country:US
Mailing Address - Phone:507-399-1382
Mailing Address - Fax:
Practice Address - Street 1:4631 CLAUSEN AVE
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1641
Practice Address - Country:US
Practice Address - Phone:507-399-1382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-23
Last Update Date:2018-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.402590163W00000X
IL209.017814363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse