Healthcare Provider Details

I. General information

NPI: 1881092021
Provider Name (Legal Business Name): REBECCA J MCLAUGHLIN APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2014
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 DELNOR DR STE 401
GENEVA IL
60134-4235
US

IV. Provider business mailing address

351 DELNOR DR STE 401
GENEVA IL
60134-4235
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4056
  • Fax:
Mailing address:
  • Phone: 630-933-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number041315855
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209011919
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: