Provider Demographics
NPI:1740518299
Name:PAONE, PATRICIA A (APN, CNP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:PAONE
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 1:720 OSTERMAN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4471
Mailing Address - Country:US
Mailing Address - Phone:847-945-9470
Mailing Address - Fax:847-945-9499
Practice Address - Street 1:720 OSTERMAN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4471
Practice Address - Country:US
Practice Address - Phone:847-945-9470
Practice Address - Fax:847-945-9499
Is Sole Proprietor?:No
Enumeration Date:2009-11-20
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-299588163W00000X
IL209-001744363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL202300006Medicare PIN
IL202301006Medicare PIN