Provider Demographics
NPI:1770083784
Name:ATCHA, SANA (FNP-BC)
Entity type:Individual
Prefix:
First Name:SANA
Middle Name:
Last Name:ATCHA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TIFFANY PT STE 106
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2915
Mailing Address - Country:US
Mailing Address - Phone:224-653-9507
Mailing Address - Fax:224-653-9387
Practice Address - Street 1:1 TIFFANY PT STE 106
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2915
Practice Address - Country:US
Practice Address - Phone:224-653-9507
Practice Address - Fax:224-653-9387
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017115363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily