Carolle M Derradji
Nurse Practitioner (Family)

Address: 3256 W Potomac Ave, Chicago, IL 60651-2411
Phone: 7082806164

Carolle M Derradji (NPI# 1265033385) 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) 1265033385
Entity Type Individual
Full Name Carolle M Derradji
Gender Female
Practice Address 3256 W Potomac Ave
Chicago
IL 60651-2411
Practice Telephone 7082806164
Mailing Address 3256 W Potomac Ave
Chicago
IL 60651-2411
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2020-11-04
Last Update Date 2020-11-04

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LF0000X Nurse Practitioner · Family Physician Assistants & Advanced Practice Nursing Providers 209.022245 IL

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to comeā€¦

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Office Location

Street Address 3256 W POTOMAC AVE
City CHICAGO
State IL
Zip Code 60651-2411

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215474978 Kanesha Walker Amaro Counselor 5910 W Division, Chicago, IL 60651 2017-01-19
1639628415 Fresenius Medical Care of Illinois, LLC Clinic/Center 3520 West Grand, Chicago, IL 60651 2016-09-22
1326596321 Giselle Tisha Wallace Nurse's Aide 5809 W Rice, Chgo, IL 60651 2016-09-19
1811385214 Jeanette Rodriguez Social Worker 1116 N Kedzie Av. Office#257, Association House of Chicago, Chicago, IL 60651 2015-01-07
1801147475 Diane Dickens-rogers Massage Therapist 5700 W. Chicago Ave., Chicago, IL 60651 2012-09-24
1891045241 Association House of Chicago Residential Treatment Facility, Emotionally Disturbed Children 1900 North Sawyer Avenue, Chicago, IL 60651 2012-09-13
1770860983 Christine C Osborne Pharmacist 1541 N.central Ave, Chicago, IL 60651 2011-11-16
1629206388 Habilitative Systems Inc Case Management 1049 N Drake Ave, Chicago, IL 60651 2009-07-01
1841428547 Habilitative Systems, Inc. Case Management 4234 W Potomac Ave, Chicago, IL 60651 2009-07-01
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Competitor

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City CHICAGO
Zip Code 60651

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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.