Paulina Petrishka
Nurse Practitioner (Adult Health)

Address: 1115 N Crosby St # C, Chicago, IL 60610-2405
Phone: 7734698545

Paulina Petrishka (NPI# 1952828980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1952828980
Entity Type Individual
Full Name Paulina Petrishka
Credential NP
Gender Female
Practice Address 1115 N Crosby St # C
IL 60610-2405
Practice Telephone 7734698545
Mailing Address 1115 N Crosby St # C
IL 60610-2405
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2017-08-30
Last Update Date 2017-08-30

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LA2200X Nurse Practitioner · Adult Health Physician Assistants & Advanced Practice Nursing Providers 209016252 IL
No 363LG0600X Nurse Practitioner · Gerontology Physician Assistants & Advanced Practice Nursing Providers 209016252 IL
No 363LP2300X Nurse Practitioner · Primary Care Physician Assistants & Advanced Practice Nursing Providers 209016252 IL

Physician Overview

NPI 1952828980
PAC ID by PECOS 6305195892
Professional Enrollment ID I20180816000909
Full Name Paulina Petrishka
Phone Number 7737021000
Gender F
Graduation Year 2016
Group Practice PAC ID 7719899426
Number of Group Practice Members 865
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name

Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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1942796123 Elizabeth R Reyna Nurse Practitioner 5841 S Maryland Ave # Mc7120, Chicago, IL 60637-1443 2018-07-10
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Office Location

Street Address 1115 N CROSBY ST # C
State IL
Zip Code 60610-2405

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326683145 Roslyn M Jordan Counselor 860 N. Lasalle, Chicago, IL 60610 2019-11-15
1992278196 Deangela Roberson Specialist/Technologist, Other 1212 N. Lasalle, Ste 100/ Surgery Center, Chicago, IL 60610 2019-01-10
1477053205 Terri Lynn Tyson Counselor 1250 N. Dearborn St., 18b, Chicago, IL 60610 2018-02-19
1487153797 Jennifer Quinn Social Worker 1200 N. Lasalle Street, Chicago, IL 60610 2018-02-02
1811415334 Erin Conroy Behavior Analyst 1400 North Lake Shore Drive Apt 8a, Chicago, IL 60610 2017-09-05
1659898674 Courtney Jane Busing Speech-Language Pathologist 1211 N Lasalle, 903, Chicago, IL 60610 2017-08-30
1528503042 Luxottica of America Inc. Eyewear Supplier 908 North State Street, Chicago, IL 60610 2016-12-20
1548702814 Melissa Snyder Counselor 1820 N Lasalle Blvd, Counseling- Sweeting, Chicago, IL 60610 2016-11-17
1982146908 Samantha Ruth Slagh Physical Therapist 1100 N Lasalle Street, Apt 1018, Chicago, IL 60610 2016-11-08
1891242426 Stephanie Pinsler Counselor 100 W Chestnut, #1907, Chicago, IL 60610 2016-09-01
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Zip Code 60610

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.