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General NPI Number Information
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NPI Number | 1497558704
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Entity Type | Individual
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Provider Name | MARLIN CERVANTES APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 401 GREENLEAF ST STE 1
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City | PARK CITY
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State | IL
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Zip | 60085-5744
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Country | US
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Telephone | 847-662-0978
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Fax | 847-662-1395
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Provider Business Mailing Address
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Address Line | 401 GREENLEAF ST STE 1
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City | PARK CITY
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State | IL
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Zip | 60085-5744
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Country | US
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Telephone | 847-662-0978
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.031646
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License Number State | IL
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