Provider Demographics
NPI:1386831212
Name:RANGEL, YADIRA XIOMARA (APN)
Entity Type:Individual
Prefix:MRS
First Name:YADIRA
Middle Name:XIOMARA
Last Name:RANGEL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4813 W 84TH ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-2787
Mailing Address - Country:US
Mailing Address - Phone:708-952-0048
Mailing Address - Fax:773-665-6027
Practice Address - Street 1:1S260 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3941
Practice Address - Country:US
Practice Address - Phone:630-953-6600
Practice Address - Fax:630-953-6619
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist