Komperda, Mary

Komperda, Mary is an individual health care provider with primary practice located at 675 W North Ave Ste-210, Melrose Park IL 60160-1634. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Komperda, Mary can be contacted via phone (708) 450-5094.

Contact Information

Primary practice address
675 W North Ave Ste-210 Melrose Park IL 60160-1634
Phone: (708) 450-5094
Fax: (708) 344-0508
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209-004003 Illinois

Profile Details

NPI number 1881640902
LBN Legal business name Komperda, Mary
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Aug 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881640902 NPPES
Illinois Other 209712 MEDICARE GROUP NUMBER
Illinois Other 31602469 MEDICARE GROUP NUMBER
Illinois Other P00236752 MEDICARE GROUP NUMBER
Illinois Other 1164530713 MEDICARE GROUP NUMBER
Illinois Other 961280 MEDICARE GROUP NUMBER
Illinois Other CC1592 MEDICARE GROUP NUMBER
Illinois Other K18549 MEDICARE GROUP NUMBER

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