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General NPI Number Information
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NPI Number | 1053885368
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Entity Type | Organization
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Legal Business Name | MYNPCARE LLC
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Dates
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Enumeration Date | 01/20/2019
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Last Update Date | 01/20/2019
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Provider Practice Location Address
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Address Line | 68 BROOKSTONE DR
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City | STREAMWOOD
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State | IL
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Zip | 60107-2311
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Country | US
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Telephone | 847-674-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 68 BROOKSTONE DR
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City | STREAMWOOD
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State | IL
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Zip | 60107-2311
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Country | US
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Telephone | 847-674-5224
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | LADY MAY ORACION PANELO
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Credential | FNP-C
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Telephone | 847-674-5224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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