Individual provider · Type 1 NPI
Mohamad Ata
Nurse Practitioner · Champaign, IL
Practice location
1802 S. Mattis
Champaign, IL 61821
Fax (630) 690-5282
Mailing address
611 W. Park St., Fapc
Urbana, IL 61801
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 209017185 (IL) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209017185 (IL) |
| Registered Nurse | 163W00000X | 041398787 (IL) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1457698169
Mohamad Ata's National Provider Identifier is 1457698169, issued on Jan 15, 2013. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Champaign, IL. The record was last updated on Sep 4, 2025.