MRS. ZYRA DONNANIECE GORDON-SMITH DNP APN CS-FNP NPI 1356459432

NPI Information

NPI: 1356459432
Provider Name: MRS. ZYRA DONNANIECE GORDON-SMITH, DNP, APN, CS-FNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
9718 S. HALSTED
CHICAGO, IL
ZIP 60628
Phone: (773) 233-4100
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MRS. Zyra Donnaniece Gordon-smith, DNP, APN, CS-FNP is a family nurse practitioner in Chicago, IL with 25 years of experience. MRS. Zyra Donnaniece Gordon-smith, DNP, APN, CS-FNP NPI is 1356459432. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduation Year:1999

The provider's business location address is:

9718 S. HALSTED
CHICAGO, IL
ZIP 60628
Phone: (773) 233-4100
Fax: (773) 233-8542

The NPI 1356459432 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/28/2006 and was last updated on 7/22/2021.

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
1	363LF0000X	Nurse Practitioner	Family	209.001637	ILLINOIS	Yes
2	363LF0000X	Nurse Practitioner	Family	041204964	ILLINOIS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	209.001637	MEDICAID	ILLINOIS

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: 4/28/2024

NPI Synchronization or Removal

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