Provider Demographics
NPI:1477887727
Name:DECARLO, BARBARA (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:DECARLO
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 DEAN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1577
Mailing Address - Country:US
Mailing Address - Phone:630-584-2400
Mailing Address - Fax:630-584-2404
Practice Address - Street 1:2015 DEAN ST STE 2
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1577
Practice Address - Country:US
Practice Address - Phone:630-584-2400
Practice Address - Fax:630-584-2404
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007726363LF0000X
IL277000344363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily