Provider Demographics
NPI:1558137216
Name:NAVARRO, DANIELLA PETRA
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:PETRA
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CAYMAN DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-2603
Mailing Address - Country:US
Mailing Address - Phone:630-644-9888
Mailing Address - Fax:
Practice Address - Street 1:12446 S VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-2700
Practice Address - Country:US
Practice Address - Phone:815-261-0126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator