Provider Demographics
NPI:1669883112
Name:FERNANDEZ, KAREN (FNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27W311 FLEMING DR
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1043
Mailing Address - Country:US
Mailing Address - Phone:312-375-8451
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:877-993-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-17
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAPRN-193416207Q00000X
OR202214276NP-PP207Q00000X
HIAPRN-3593207Q00000X
NM67376207Q00000X
IL277.001988363LF0000X
AZ274022207Q00000X
CA95023590207Q00000X
AK191815207Q00000X
WAAP61282106207Q00000X
MO2024043478207Q00000X
TX1177580207Q00000X
MN9225207Q00000X
IN71016045A207Q00000X
NV883859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine