Basic Information
Provider Information
NPI: 1538567490
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELA CRUZ
FirstName: ALISON
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 909 E PALATINE RD
Address2:  
City: PALATINE
State: IL
PostalCode: 600745551
CountryCode: US
TelephoneNumber: 8477761400
FaxNumber: 8477761864
Practice Location
Address1: 909 E PALATINE RD
Address2:  
City: PALATINE
State: IL
PostalCode: 600745551
CountryCode: US
TelephoneNumber: 8477761400
FaxNumber: 8477761424
Other Information
ProviderEnumerationDate: 12/09/2014
LastUpdateDate: 03/01/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X041367997ILN Nursing Service ProvidersRegistered Nurse 
363L00000X2090120127ILY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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