Provider Demographics
NPI:1841511896
Name:TUTOR, NANCY ANGELINE (APN, CNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANGELINE
Last Name:TUTOR
Suffix:
Gender:F
Credentials:APN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W FULTON ST
Mailing Address - Street 2:#408
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1431 N WESTERN AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1797
Practice Address - Country:US
Practice Address - Phone:312-332-2226
Practice Address - Fax:773-276-1197
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.371573163W00000X
TN162394163W00000X
IL209.007617363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse