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General NPI Number Information
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NPI Number | 1013717834
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Entity Type | Individual
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Provider Name | TIARA CANG ESCONDO
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 5101 WILLOW SPRINGS RD
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City | LA GRANGE
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State | IL
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Zip | 60525-2600
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Country | US
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Telephone | 708-245-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 6711 HALEY CT
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City | PLAINFIELD
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State | IL
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Zip | 60586-2605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 209.030995
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License Number State | IL
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