IndividualActive
Ajie Mammarappallil, AGACNP
NPI 1215510987 · Acute Care Nurse Practitioner · Palos Heights, IL
Provider details
- NPI number
- 1215510987
- Entity type
- Individual
- Primary specialty
- Acute Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGACNP
- Sex
- Female
- Sole proprietor
- No
- License
- 209022913 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
12251 S 80th Ave
Palos Heights, IL 60463-1290
Phone: (708) 923-4000
Approximate (ZIP-level) locationGet directions
Mailing address
17704 Radcliffe Ct
Tinley Park, IL 60487-2291
Registry dates
- Enumerated
- 2021-04-30
- Last updated
- 2021-04-30
- Certified
- 2021-04-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.