Provider Demographics
NPI:1740651140
Name:NAWROCKI, MAGGIE E (APRN, CNP)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:E
Last Name:NAWROCKI
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:KEUTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:680 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 810
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4546
Mailing Address - Country:US
Mailing Address - Phone:312-926-8811
Mailing Address - Fax:
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:SUITE 810
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-926-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041383091163W00000X
IL209013248363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse