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General NPI Number Information
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NPI Number | 1477887727
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Entity Type | Individual
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Provider Name | BARBARA DECARLO APRN, CNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2009
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 2015 DEAN ST STE 2
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City | ST CHARLES
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State | IL
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Zip | 60174-1577
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Country | US
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Telephone | 630-584-2400
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Fax | 630-584-2404
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Provider Business Mailing Address
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Address Line | 2015 DEAN ST STE 2
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City | ST CHARLES
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State | IL
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Zip | 60174-1577
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Country | US
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Telephone | 630-584-2400
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Fax | 630-584-2404
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209007726
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 277000344
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License Number State | IL
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