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General NPI Number Information
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NPI Number | 1801557319
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Entity Type | Individual
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Provider Name | CLAUDIA A ROLDAN FNP
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Gender | Female
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Dates
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Enumeration Date | 01/06/2022
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 2550 OAK PARK AVE
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City | BERWYN
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State | IL
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Zip | 60402-4661
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Country | US
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Telephone | 708-575-6757
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Fax | 877-653-2695
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Provider Business Mailing Address
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Address Line | 1736 N WASHTENAW AVE
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City | CHICAGO
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State | IL
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Zip | 60647-0724
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Country | US
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Telephone | 773-443-5156
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 041400346
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209024752
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License Number State | IL
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