Healthcare Provider Details

I. General information

NPI: 1851278634
Provider Name (Legal Business Name): ARIA ROSE DEGILLIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N KIMBALL AVE APT 2
CHICAGO IL
60647-1266
US

IV. Provider business mailing address

2501 N KIMBALL AVE APT 2
CHICAGO IL
60647-1266
US

V. Phone/Fax

Practice location:
  • Phone: 312-852-1672
  • Fax:
Mailing address:
  • Phone: 312-852-1672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number041522961
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: