Provider Demographics
NPI:1467949594
Name:ALMORES, HAZEL H (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:H
Last Name:ALMORES
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NAVISTAR DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3661
Mailing Address - Country:US
Mailing Address - Phone:224-273-3381
Mailing Address - Fax:
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:EAST TOWER, STE 360
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202
Practice Address - Country:US
Practice Address - Phone:847-316-2635
Practice Address - Fax:847-316-2634
Is Sole Proprietor?:No
Enumeration Date:2018-04-14
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017301363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041280583OtherPROFESSIONAL REGISTERED NURSE
IL209017301OtherADVANCED PRACTICE NURSE LICENSE