Provider Demographics
NPI:1952030470
Name:PARCON, ADELAIDA AGUJITAS (RN)
Entity Type:Individual
Prefix:
First Name:ADELAIDA
Middle Name:AGUJITAS
Last Name:PARCON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 LILAC DR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4976
Mailing Address - Country:US
Mailing Address - Phone:630-544-4117
Mailing Address - Fax:
Practice Address - Street 1:1740 W TAYLOR STREET
Practice Address - Street 2:7E STEPDOWN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-413-1472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041295180163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse