Healthcare Provider Details

I. General information

NPI: 1457277857
Provider Name (Legal Business Name): GINA GERALDINE GANZON CALINGACION
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 PFINGSTEN RD
GLENVIEW IL
60026-1301
US

IV. Provider business mailing address

5258 LEE ST
SKOKIE IL
60077-2166
US

V. Phone/Fax

Practice location:
  • Phone: 847-503-8100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.433544
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: