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General NPI Number Information
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NPI Number | 1518789593
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Entity Type | Individual
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Provider Name | CONSTANZA GONZALEZ ARANCIBIA NP
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 225 W. WASHINGTON ST. SUITE 1700
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City | CHICAGO
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State | IL
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Zip | 60606
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Country | US
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Telephone | 855-493-5523
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Fax |
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Provider Business Mailing Address
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Address Line | 44 MACDERMOTT DRIVE
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City | AJAX
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State | ON
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Zip | L1T 3T5
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Country | CA
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209.030826
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License Number State | IL
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