Doctor Name: | MRS. MARCELLA INGARRA CIMINO |
NPI Number: | 1265573117 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | |
Business Practice Address: | 1515 E Lake St Hanover Park, IL - 601334896 |
Business Phone Number: | 6308305926 |
Business Fax Number: | |
Mailing Address: | 22 Country Club Dr, BLOOMINGDALE |
State: | IL |
Postal Code: | 601081248 |
Phone Number: | 6309809733 |
Fax Number: | |
NPI Enumeration Date: | 02/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |