Healthcare Provider Details

I. General information

NPI: 1346297025
Provider Name (Legal Business Name): PATRICIA VIGNOCCHI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 RAVINE WAY SUITE 200
GLENVIEW IL
60025-7645
US

IV. Provider business mailing address

8930 WAUKEGAN RD SUITE 200 - ATTN: RAQUEL LEON
MORTON GROVE IL
60053-2126
US

V. Phone/Fax

Practice location:
  • Phone: 847-998-5680
  • Fax:
Mailing address:
  • Phone: 847-324-3976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: