Healthcare Provider Details

I. General information

NPI: 1215807359
Provider Name (Legal Business Name): DIANE PROANO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HARPER DR
ALGONQUIN IL
60102-2086
US

IV. Provider business mailing address

325 HARPER DR
ALGONQUIN IL
60102-2086
US

V. Phone/Fax

Practice location:
  • Phone: 847-254-3884
  • Fax:
Mailing address:
  • Phone: 847-254-3884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.033902
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: