Provider Demographics
NPI:1457400673
Name:PAPINEAU, CAROL ANNE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:ANNE
Last Name:PAPINEAU
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:310 S GREENLEAF ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5708
Mailing Address - Country:US
Mailing Address - Phone:847-625-6375
Mailing Address - Fax:847-662-3557
Practice Address - Street 1:310 S GREENLEAF ST
Practice Address - Street 2:SUITE 201
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5708
Practice Address - Country:US
Practice Address - Phone:847-662-4380
Practice Address - Fax:847-662-3557
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics