Provider Demographics
NPI:1588800700
Name:GARZA, SYLVIA ANN (APN-BC)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:ANN
Last Name:GARZA
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W STATE ST
Mailing Address - Street 2:CRUSADER CLINIC
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61102-2112
Mailing Address - Country:US
Mailing Address - Phone:815-490-1600
Mailing Address - Fax:
Practice Address - Street 1:1200 STATE STREET
Practice Address - Street 2:CRUSADER CLINIC
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61102
Practice Address - Country:US
Practice Address - Phone:815-490-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.007375363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL421060724003Medicaid
IA1710971486Medicaid
IL209007375OtherIL LICENSE
IL8122859OtherBC/BS IL GROUP
IL207707Medicare Oscar/Certification