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NPI Code Detail

MEDICARE: ANNIE RANGEL APRN, ACNPC-AG

MEDICARE: ANNIE RANGEL APRN, ACNPC-AG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner209.033522IL
2390200000XStudent in an Organized Health Care Education/Training Program209.033522IL

General Provider Information

NPI Number : 1093674517
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNIE RANGEL APRN, ACNPC-AG
Provider Business Mailing Address
First Line : 4440 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4440 W 95TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-2600
Country : US
Telephone Number : 708-684-9230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 03/16/2026

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