Healthcare Provider Details

I. General information

NPI: 1740665082
Provider Name (Legal Business Name): SWAPNA BABU FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E DUNDEE RD
BUFFALO GROVE IL
60089-4384
US

IV. Provider business mailing address

5230 MORNINGVIEW DR
HOFFMAN ESTATES IL
60192-4105
US

V. Phone/Fax

Practice location:
  • Phone: 815-464-2171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209012951
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: