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General NPI Number Information
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NPI Number | 1093625766
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Entity Type | Individual
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Provider Name | ANGIE REIST RN, PEL-CSN
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Gender |
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 441 N FARNSWORTH AVE
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City | AURORA
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State | IL
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Zip | 60505-3002
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Country | US
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Telephone | 630-299-5915
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Fax |
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Provider Business Mailing Address
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Address Line | 441 N FARNSWORTH AVE
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City | AURORA
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State | IL
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Zip | 60505-3010
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 1961624
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License Number State | IL
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