Provider Demographics
NPI:1427314707
Name:AUSTIN, CLAUDIA D (APN)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:D
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 W. CHICAGO AVE.
Mailing Address - Street 2:COMMUMITY HEALTH CLINIC
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622
Mailing Address - Country:US
Mailing Address - Phone:773-395-9900
Mailing Address - Fax:
Practice Address - Street 1:2611 W. CHICAGO AVE.
Practice Address - Street 2:COMMUMITY HEALTH CLINIC
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:773-395-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209001605363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health