Mary Elizabeth Waterloo

Nurse Practitioner · Homewood, IL

Individual Active NPI

NPI number 1720634827

Practice location

17901 Governors Hwy Ste 206
Homewood, IL 60430-1146
Phone
(708) 960-4280

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NPI record

NPI
1720634827
Entity type
Individual (Type 1)
Enumeration date
August 14, 2019
Last updated
November 11, 2021
Certified
November 11, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nurse Practitioner Primary 363L00000X 209019819 IL

Mailing address

2160 S 1st Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000

About Mary Waterloo

Mary Elizabeth Waterloo is a healthcare provider registered in the NPI registry with the primary taxonomy Nurse Practitioner (code 363L00000X). The practice location is 17901 Governors Hwy Ste 206, Homewood, IL 60430-1146. The NPI number 1720634827 was assigned on August 14, 2019 and the record was last updated on November 11, 2021.

Mary Waterloo lists a license in the registry: #209019819 (IL) for Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mary Elizabeth Waterloo?

The NPI number is 1720634827.

What is the phone number of Mary Waterloo?

The phone number listed for the practice location is (708) 960-4280.

Where is Mary Waterloo located?

17901 Governors Hwy Ste 206, Homewood, IL 60430-1146.

What is the taxonomy code for Mary Waterloo?

The primary taxonomy code is 363L00000X – Nurse Practitioner.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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