Provider Demographics
NPI:1962946483
Name:PAGEL, JULIE (FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PAGEL
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 1:674 FAIRWAY LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9018
Mailing Address - Country:US
Mailing Address - Phone:715-574-3157
Mailing Address - Fax:
Practice Address - Street 1:10755 W 143RD ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462
Practice Address - Country:US
Practice Address - Phone:708-590-7150
Practice Address - Fax:708-590-7151
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209015119363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily