MARGUERITE A WYDRA NPI 1255694568

NPI Information

  • NPI: 1255694568
  • Provider Name: MARGUERITE A WYDRA
  • Classification: Clinical Nurse Specialist - 364SP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1653 W. CONGRESS PKWY
    622 MURDOCK
    CHICAGO, IL
    ZIP 60612
  • Phone: (312) 942-6194

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NPI Details

Marguerite A Wydra is a pediatrics clinical nurse specialist in Chicago, IL. Marguerite A Wydra NPI is 1255694568. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1653 W. CONGRESS PKWY
622 MURDOCK
CHICAGO, IL
ZIP 60612
Phone: (312) 942-6194
Fax: (312) 942-4370

The NPI 1255694568 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2012 and was last updated on 6/21/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1364SP0200XClinical Nurse SpecialistPediatrics209-008510ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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