Provider Demographics
NPI:1477032316
Name:DAGURO-ROBLEDO, KATHELYN SIM (APN, MSN-FNP)
Entity Type:Individual
Prefix:
First Name:KATHELYN
Middle Name:SIM
Last Name:DAGURO-ROBLEDO
Suffix:
Gender:F
Credentials:APN, MSN-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 S EOLA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60503-6410
Mailing Address - Country:US
Mailing Address - Phone:630-692-5190
Mailing Address - Fax:630-692-5185
Practice Address - Street 1:2340 S EOLA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60503-6409
Practice Address - Country:US
Practice Address - Phone:630-692-5190
Practice Address - Fax:630-692-5185
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-11
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.017732363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily