Organization · Type 2 NPI
Vanguard Eldercare Medical Group - Illinois SC
Family Nurse Practitioner · Homer Glen, IL
NPI number
1891339487
Active
Practice location
12600 Renaissance Cir
Homer Glen, IL 60491-5891
Fax (574) 546-1999
Mailing address
2100 N Main St Ste 301, One Professional Center
Crown Point, IN 46307-1877
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Psychologist | 103TC0700X | None listed |
| Nurse Practitioner | 363L00000X | None listed |
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
3 other providers at this address
About NPI 1891339487
Vanguard Eldercare Medical Group - Illinois SC's National Provider Identifier is 1891339487, issued on Nov 6, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Homer Glen, IL. The record was last updated on Apr 23, 2021.