Provider Demographics
NPI:1285917542
Name:MULE, NANCY MARIA (PA-C)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIA
Last Name:MULE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 W PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-5242
Mailing Address - Country:US
Mailing Address - Phone:773-508-9800
Mailing Address - Fax:773-508-1796
Practice Address - Street 1:2320 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-5242
Practice Address - Country:US
Practice Address - Phone:773-508-9800
Practice Address - Fax:773-508-1796
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085004139363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant