Provider Demographics
NPI:1447477401
Name:RAMSBURG, ANNETTE SUE (WHCNP)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:SUE
Last Name:RAMSBURG
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 W. UNIVERSITY AVE.
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-3921
Mailing Address - Country:US
Mailing Address - Phone:217-355-8307
Mailing Address - Fax:
Practice Address - Street 1:5086 ELSTON AVE.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630
Practice Address - Country:US
Practice Address - Phone:773-725-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003356363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL83615 GRP PIN 62620Medicare ID - Type Unspecified