Healthcare Provider Details

I. General information

NPI: 1225545379
Provider Name (Legal Business Name): JOAN REMBACZ RN, APN, CCNS, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 01/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 W MEDICAL CENTER DR
MCHENRY IL
60050-8409
US

IV. Provider business mailing address

58 GEORGETOWN DR
CARY IL
60013-1874
US

V. Phone/Fax

Practice location:
  • Phone: 815-759-4015
  • Fax: 815-759-4110
Mailing address:
  • Phone: 847-791-1765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number209.000949
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: