| Amy Brogley, | |
|
1324 N Sheridan Rd, Waukegan, IL 60085-2161 | |
| (847) 360-3000 | |
| Not Available |
| Full Name | Amy Brogley |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1324 N Sheridan Rd, Waukegan, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598335564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN.481312 (Ohio) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 209.028581 (Illinois) | Primary |
| Entity Name | Waukegan Clinic Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306937289 PECOS PAC ID: 4284631086 Enrollment ID: O20061108000240 |
| Entity Name | G & G Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487020111 PECOS PAC ID: 4981912607 Enrollment ID: O20150930000831 |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Brogley, 2030 N 51st St, Milwaukee, WI 53208-1746 Ph: (608) 732-4755 | Amy Brogley, 1324 N Sheridan Rd, Waukegan, IL 60085-2161 Ph: (847) 360-3000 |
Lynn M. Ulrich, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1324 N Sheridan Rd, Waukegan, IL 60085 Phone: 847-360-3000 | |
Ms. Maria A. Hobbs, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1324 N Sheridan Rd, Waukegan, IL 60085 Phone: 847-360-3000 | |
Ms. Ebele Okonkwor, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1324 N. Sheridan, Waukegan, IL 60085 Phone: 847-360-3000 |