Healthcare Provider Details

I. General information

NPI: 1386340784
Provider Name (Legal Business Name): ANA R AGUIRRE RUVALCABA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13415 ILLINOIS RTE 59
PLAINFIELD IL
60585
US

IV. Provider business mailing address

6012 CHERRY RIDGE DR
PLAINFIELD IL
60586-5386
US

V. Phone/Fax

Practice location:
  • Phone: 815-609-3627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.026054
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: