Basic Information
| Provider Information | |||||||||
| NPI: | 1669566782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POPE-OSAGHAE | ||||||||
| FirstName: | NINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3580 SCOTTSDALE CIR | ||||||||
| Address2: | |||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605644628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303054335 | ||||||||
| FaxNumber: | 6303054125 | ||||||||
| Practice Location | |||||||||
| Address1: | 3035 BOOK RD | ||||||||
| Address2: | 3580 SCOTTSDALE CIRCLE | ||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605644715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668253227 | ||||||||
| FaxNumber: | 4843513800 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 10/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 209004787 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | 209004787 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.