Basic Information
| Provider Information | |||||||||
| NPI: | 1750625562 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VENTURELLA | ||||||||
| FirstName: | VICTORIA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11001 DEER CREEK DR | ||||||||
| Address2: | |||||||||
| City: | CROWN POINT | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463077141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128481410 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 INGALLS DR | ||||||||
| Address2: | |||||||||
| City: | HARVEY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604263558 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7083332300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2012 | ||||||||
| LastUpdateDate: | 02/09/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 5005921 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 209010202 | IL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 71004297A | IN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 209010202 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.