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Mrs. Terrah Koppie Gavrilos, APN,CNP
Family Nurse Practitioner in Lake Bluff, Illinois
NPI 1396250346

Terrah Koppie Gavrilos is a Family Nurse Practitioner based in North Barrington, IL and is specialized in Family. Terrah Koppie Gavrilos practices in Lake Bluff, IL and has the professional credentials of APN,CNP. The NPI Number for Terrah Koppie Gavrilos is 1396250346 and holds a License No. 209015215 (Illinois).

The current practice location address for Terrah Koppie Gavrilos is 925 Sherwood Dr, Lake Bluff, IL and can be reached out via phone at 847-234-1177 and via fax at 847-234-1875.

Location: 925 Sherwood Dr, Lake Bluff, IL, 60010-2111
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396250346
Provider Name
Terrah Koppie Gavrilos
Credential
APN,CNP
Provider Entity Type
Individual
Gender
Female
Address
925 Sherwood Dr, Lake Bluff, IL, 60010-2111
Phone Number
847-234-1177
Fax Number
847-234-1875
Provider Enumeration Date
12/12/2017
Last Update Date
08/17/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
309010634 01 IL APN CONTROLLED SUBSTANCE
209105215 01 IL APN
041374819 01 IL REGISTERED PROFESSIONAL NURSE
1396250346 05 IL
institution
Provider Business Practice Location Address Details
Address
925 Sherwood Dr
City
Lake Bluff
State
Illinois
Zip
60044-2203
Phone Number
847-234-1177
Fax Number
847-234-1875
person
Provider Business Mailing Address Details
Address
925 Sherwood Dr
City
Lake Bluff
State
Illinois
Zip
60044-2203
Phone Number
847-234-1177
Fax Number
847-234-1875
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
209015215 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
363LP0200X
License No.
209015215 (Illinois)
Definition
Definition to come...
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