Basic Information
| Provider Information | |||||||||
| NPI: | 1376031625 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAVER | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 W GALENA BLVD | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605064305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306925960 | ||||||||
| FaxNumber: | 6306925961 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 W GALENA BLVD | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605064305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6306925960 | ||||||||
| FaxNumber: | 6306925961 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2018 | ||||||||
| LastUpdateDate: | 06/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 041.318860 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 041.318860 | IL | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 209018254 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.