Healthcare Provider Details

I. General information

NPI: 1366466989
Provider Name (Legal Business Name): GAIL L DELUCA R.N.,A.P.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 N RANDALL RD STE 200
ELGIN IL
60123-9402
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-2207
US

V. Phone/Fax

Practice location:
  • Phone: 847-214-5740
  • Fax: 847-214-5757
Mailing address:
  • Phone: 847-390-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-001626
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: