Healthcare Provider Details

I. General information

NPI: 1710703228
Provider Name (Legal Business Name): ROCIO VARGAS CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2024
Last Update Date: 11/29/2024
Certification Date: 11/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 HARNISH DR STE 101
ALGONQUIN IL
60102-6803
US

IV. Provider business mailing address

460 FARTHING LN
DES PLAINES IL
60016-2708
US

V. Phone/Fax

Practice location:
  • Phone: 224-333-0730
  • Fax: 224-333-0748
Mailing address:
  • Phone: 224-636-0974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209.029971
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: