Provider Demographics
NPI:1437813805
Name:DEGUZMAN, PEARLANE (RN)
Entity Type:Individual
Prefix:
First Name:PEARLANE
Middle Name:
Last Name:DEGUZMAN
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 1:8839 SAYRE AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2034
Mailing Address - Country:US
Mailing Address - Phone:224-616-0668
Mailing Address - Fax:
Practice Address - Street 1:8839 SAYRE AVE
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2034
Practice Address - Country:US
Practice Address - Phone:224-616-0668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202003723RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse