MRS. GERMAINE A DESRUISSEAUX NP NPI 1578752051

NPI Information

NPI: 1578752051
Provider Name: MRS. GERMAINE A DESRUISSEAUX, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1228 E 53RD ST
CHICAGO, IL
ZIP 60615
Phone: (773) 752-1425
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MRS. Germaine A Desruisseaux, NP is a family nurse practitioner in Chicago, IL. MRS. Germaine A Desruisseaux, NP NPI is 1578752051. 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:

1228 E 53RD ST
CHICAGO, IL
ZIP 60615-008
Phone: (773) 752-1425

The NPI 1578752051 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 10/19/2007 and was last updated on 10/17/2017.

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	209006672	ILLINOIS	Yes

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	R00825	MEDICARE UPIN	ILLINOIS
2	R00824	MEDICARE UPIN	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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