Provider Demographics
NPI:1982118279
Name:OLLE, DEANNDRA (APRN)
Entity type:Individual
Prefix:
First Name:DEANNDRA
Middle Name:
Last Name:OLLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 DEMPSTER ST STE 665
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1168
Mailing Address - Country:US
Mailing Address - Phone:847-825-1590
Mailing Address - Fax:847-825-1604
Practice Address - Street 1:1875 DEMPSTER ST STE 665
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1168
Practice Address - Country:US
Practice Address - Phone:847-825-1590
Practice Address - Fax:847-825-1604
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPENDING363LW0102X
IL209016991363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health