DAWNELLE MARIE-VARGAS GORDON PMHNP-BC ARNP APNP NPI 1780647586

NPI Information

NPI: 1780647586
Provider Name: DAWNELLE MARIE-VARGAS GORDON, PMHNP-BC, ARNP, APNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
2150 W HARRISON ST
CHICAGO, IL
ZIP 60612
Phone: (312) 942-5375
Get Directions

Dawnelle Marie-vargas Gordon, PMHNP-BC, ARNP, APNP is a psychiatric/mental health nurse practitioner in Chicago, IL. Dawnelle Marie-vargas Gordon, PMHNP-BC, ARNP, APNP NPI is 1780647586. 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:

2150 W HARRISON ST
CHICAGO, IL
ZIP 60612-706
Phone: (312) 942-5375

The NPI 1780647586 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 4/11/2006 and was last updated on 4/5/2022.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	209005943	ILLINOIS	Yes
2	363L00000X	Nurse Practitioner		209005943	ILLINOIS	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	G-113375	IOWA	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	7345-33	WISCONSIN	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	11851721	OTHER	IOWA	CAQH

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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