Healthcare Provider Details

I. General information

NPI: 1861306888
Provider Name (Legal Business Name): RHOELA TESORO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N SLEEPY HOLLOW LN
ROMEOVILLE IL
60446-5806
US

IV. Provider business mailing address

720 N SLEEPY HOLLOW LN
ROMEOVILLE IL
60446-5806
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-8387
  • Fax:
Mailing address:
  • Phone: 708-202-8387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041329055
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: