Healthcare Provider Details

I. General information

NPI: 1730559626
Provider Name (Legal Business Name): HEAL N CURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 WILLOW RD
NORTHBROOK IL
60062-6824
US

IV. Provider business mailing address

1122 WILLOW RD
NORTHBROOK IL
60062-6824
US

V. Phone/Fax

Practice location:
  • Phone: 847-686-4444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.011230
License Number StateIL

VIII. Authorized Official

Name: RUVINI DE VAS GUNAWARDHANE
Title or Position: FAMILY NURSE PRACTITIONER
Credential: ANP FNP-BC
Phone: 847-686-4444