Provider Demographics
NPI:1992717888
Name:PAPP, PAMELA A (NP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:PAPP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD STE 500
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1379
Mailing Address - Country:US
Mailing Address - Phone:630-232-0280
Mailing Address - Fax:630-933-3626
Practice Address - Street 1:25 N WINFIELD RD STE 500
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1379
Practice Address - Country:US
Practice Address - Phone:630-232-0280
Practice Address - Fax:630-933-3626
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004620363L00000X
IL209-004620363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400173777OtherMEDICARE PTAN (INDIVIDUAL)
IL206147OtherMEDICARE PTAN (GROUP)
IL$$$$$$$$$001Medicaid
ILK33899Medicare PIN
IL$$$$$$$$$001Medicaid