Provider Demographics
NPI:1093968364
Name:CIUPIK, ELAINE CAROL (RN)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:CAROL
Last Name:CIUPIK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11568 BURTON CT
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5912
Mailing Address - Country:US
Mailing Address - Phone:708-409-9676
Mailing Address - Fax:
Practice Address - Street 1:11568 BURTON CT
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5912
Practice Address - Country:US
Practice Address - Phone:708-409-9676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.356149163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse