Individual provider · Type 1 NPI

Mariaelena J. Fagadore, CNP

Pediatric Nurse Practitioner · Chicago, IL

NPI number 1861490138 Active

Practice location

4254 W 55th St
Chicago, IL 60632-4642

Fax (773) 582-2772

Specialties and licenses

TaxonomyCodeLicense
Pediatric Registered Nurse 163WP0200XR45506 (NM)
Pediatric Nurse Practitioner 363LP0200X9244538 (FL)
Pediatric Nurse Practitioner Primary 363LP0200X209-015320 (IL)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1861490138

Mariaelena J. Fagadore, CNP's National Provider Identifier is 1861490138, issued on Jul 12, 2005. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Chicago, IL. The record was last updated on Apr 11, 2017.