Provider Demographics
NPI:1447747142
Name:ARAIZA, SANDRA LUZ (FNP-C)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LUZ
Last Name:ARAIZA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LUZ
Other - Last Name:SALTIJERAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 CALENDAR CT
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2365
Mailing Address - Country:US
Mailing Address - Phone:708-745-5277
Mailing Address - Fax:708-579-2408
Practice Address - Street 1:110 W CALENDAR AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2325
Practice Address - Country:US
Practice Address - Phone:708-745-5277
Practice Address - Fax:708-579-2408
Is Sole Proprietor?:No
Enumeration Date:2018-04-18
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily