Healthcare Provider Details

I. General information

NPI: 1013692524
Provider Name (Legal Business Name): DENISE VIGILIA APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SPALDING DR. SUITE 207
NAPERVILLE IL
60540-6508
US

IV. Provider business mailing address

2650 RIDGE AVE, SUITE 1223
EVANSTON IL
60201
US

V. Phone/Fax

Practice location:
  • Phone: 630-646-6020
  • Fax: 630-646-6006
Mailing address:
  • Phone: 847-570-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209027191
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209027191
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: