Individual provider · NPI-1

Alice Cervantes, RN

Registered Nurse, General Practice · Chicago, IL

NPI number1932801487
StatusActive
Last updated in NPPESMar 20, 2023

Details

NPI
1932801487
Entity type
Individual (NPI-1)
Name
Alice Cervantes
Credential
RN
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 20, 2023
Certification date
Mar 20, 2023
Last updated
Mar 20, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice041389503INYes

Practice location

6821 S Halsted St
Chicago, IL 60621-1833

Phone 773-651-3629 · Fax 773-322-1599

Mailing address

7035 Kansas Ave
Hammond, IN 46323-1761

Phone 219-940-8137

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