Provider Demographics
NPI:1326097957
Name:VARGOS, CAROLYN R (RN)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:R
Last Name:VARGOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:R
Other - Last Name:CONSTANTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:327 GUNDERSEN DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2453
Mailing Address - Country:US
Mailing Address - Phone:630-665-9155
Mailing Address - Fax:630-665-5557
Practice Address - Street 1:327 GUNDERSEN DR
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2402
Practice Address - Country:US
Practice Address - Phone:630-665-9155
Practice Address - Fax:630-665-5557
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse