MEDICARE: LIEZL ESGUERRA DE OCAMPO RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0500X	Hemodialysis Registered Nurse	041598004	IL

General Provider Information

NPI Number	:	1033066956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIEZL ESGUERRA DE OCAMPO RN

Provider Business Mailing Address
First Line	:	5035 S EAST END AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-0035
Country	:	US
Telephone Number	:	626-831-2438
Fax Number	:

Provider Business Practice Location Address
First Line	:	8109 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5939
Country	:	US
Telephone Number	:	800-424-6589
Fax Number	:	773-778-0193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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