Provider Demographics
NPI:1932584620
Name:MAGIERA, VIOLETTA A (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:VIOLETTA
Middle Name:A
Last Name:MAGIERA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6755 N MILWAUKEE AVE
Mailing Address - Street 2:UNIT 511
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4499
Mailing Address - Country:US
Mailing Address - Phone:847-606-1640
Mailing Address - Fax:
Practice Address - Street 1:11200 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8208
Practice Address - Country:US
Practice Address - Phone:401-770-1614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily