Provider Demographics
NPI:1144501081
Name:O'DONNELL, MARGUERITE MARY (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:MARY
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:MARGUERITE
Other - Middle Name:MARY
Other - Last Name:BARNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:9831 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1740
Practice Address - Country:US
Practice Address - Phone:773-445-3500
Practice Address - Fax:773-445-0575
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010649363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily