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NPI Code Detail

MEDICARE: ALLAN CASANOVA DE OCAMPO RN

MEDICARE: ALLAN CASANOVA DE OCAMPO RN
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
1163W00000XRegistered Nurse041601273IL

General Provider Information

NPI Number : 1285580621
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLAN CASANOVA DE OCAMPO RN
Provider Business Mailing Address
First Line : 5035 S EAST END AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-0035
Country : US
Telephone Number : 626-831-2439
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S FAIRFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 626-831-2439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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