Healthcare Provider Details
I. General information
NPI: 1750651345
Provider Name (Legal Business Name): TERESA M SCHIRO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/12/2012
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16 S GLADSTONE AVE
AURORA IL
60506-4834
US
IV. Provider business mailing address
16 S GLADSTONE AVE
AURORA IL
60506-4834
US
V. Phone/Fax
- Phone: 630-965-3759
- Fax:
- Phone: 630-965-3759
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 041259527 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | 041259527 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: