Provider Demographics
NPI:1073523718
Name:SANCHEZ, GERARDO (RN)
Entity Type:Individual
Prefix:
First Name:GERARDO
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6785 WEAVER RD
Mailing Address - Street 2:STE D
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8055
Mailing Address - Country:US
Mailing Address - Phone:815-633-8586
Mailing Address - Fax:
Practice Address - Street 1:6785 WEAVER RD
Practice Address - Street 2:STE D
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8055
Practice Address - Country:US
Practice Address - Phone:815-633-8586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-310999163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant