Provider Demographics
NPI:1043659303
Name:RILEY, ABIGAIL LAUREN (CPNP, APNP)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:LAUREN
Last Name:RILEY
Suffix:
Gender:F
Credentials:CPNP, APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 E GRAND AVE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3311
Mailing Address - Country:US
Mailing Address - Phone:312-229-0170
Mailing Address - Fax:414-266-3338
Practice Address - Street 1:211 E GRAND AVE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3311
Practice Address - Country:US
Practice Address - Phone:312-229-0170
Practice Address - Fax:414-266-3338
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI5282-33363LP0200X
IL209014172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics