Healthcare Provider Details

I. General information

NPI: 1295565786
Provider Name (Legal Business Name): DESIREE-BIANCA SABRINA GARCIA APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DESIREE SABRINA GARCIA FNP-BC

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9555 S 52ND AVE
OAK LAWN IL
60453-3054
US

IV. Provider business mailing address

29373 NETWORK PL
CHICAGO IL
60673-1293
US

V. Phone/Fax

Practice location:
  • Phone: 708-272-4150
  • Fax: 708-229-0696
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209030235
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209030235
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041368664
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: