Provider Demographics
NPI:1811141906
Name:GIGLIO, MAUREEN J (APRN BC)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:J
Last Name:GIGLIO
Suffix:
Gender:F
Credentials:APRN BC
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Mailing Address - Street 1:1040 SIERRA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7240
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-8319
Practice Address - Street 1:3700 W 203RD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1180
Practice Address - Country:US
Practice Address - Phone:708-679-2380
Practice Address - Fax:708-503-3295
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2021-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209002847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001636111OtherBCBS
IL203979062OtherMEDICARE PTAN
IL213308005Medicare PIN