Provider Demographics
NPI:1629796925
Name:DE LA CRUZ, SUNSHINE MARY C (RN)
Entity Type:Individual
Prefix:MRS
First Name:SUNSHINE
Middle Name:MARY C
Last Name:DE LA CRUZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUNSHINE
Other - Middle Name:MARY M
Other - Last Name:CABRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:9114 WAUKEGAN RD UNIT 506
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3821
Mailing Address - Country:US
Mailing Address - Phone:847-421-7400
Mailing Address - Fax:
Practice Address - Street 1:1883 2ND ST # 38
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3113
Practice Address - Country:US
Practice Address - Phone:847-421-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-332914163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse