Provider Demographics
NPI:1992327506
Name:OFFERMAN-IZZARELLI, CHRISTINE A (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:A
Last Name:OFFERMAN-IZZARELLI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24779 S FOXFORD DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:IL
Mailing Address - Zip Code:60442-8128
Mailing Address - Country:US
Mailing Address - Phone:815-791-6596
Mailing Address - Fax:
Practice Address - Street 1:17901 GOVERNORS HWY STE 206
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1146
Practice Address - Country:US
Practice Address - Phone:708-960-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.021208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily