Provider Demographics
NPI:1336602705
Name:VARMA, AMRITA M (APN)
Entity Type:Individual
Prefix:MRS
First Name:AMRITA
Middle Name:M
Last Name:VARMA
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 1:600 W CERMAK RD UNIT 3D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2268
Mailing Address - Country:US
Mailing Address - Phone:312-427-6000
Mailing Address - Fax:312-427-6004
Practice Address - Street 1:600 W CERMAK RD UNIT 3D
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2268
Practice Address - Country:US
Practice Address - Phone:312-427-6000
Practice Address - Fax:312-427-6004
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018156363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner